Immunostimulatory nucleic acid molecules

ABSTRACT

Nucleic acids containing unmethylated CpG dinucleotides and therapeutic utilities based on their ability to stimulate an immune response and to redirect a Th2 response to a Th1 response in a subject are disclosed. Methods for treating atopic diseases, including atopic dermatitis, are disclosed.

RELATED APPLICATIONS

This application is a continuation of U.S. patent application Ser. No.09/818,918, filed Mar. 27, 2001, now abandoned, which is a divisional ofU.S. patent application Ser. No. 08/738,652, filed Oct. 30, 1996, nowissued as U.S. Pat. No. 6,207,646 B1, which is a continuation-in-part ofU.S. patent application Ser. No. 08/386,063, filed Feb. 7, 1995, nowissued as U.S. Pat. No. 6,194,388 B1, which is a continuation-in-part ofU.S. patent application Ser. No. 08/276,358, filed Jul. 15, 1994, nowabandoned.

GOVERNMENT SUPPORT

The work resulting in this invention was supported in part by NationalInstitute of Health Grant No. R29-AR42556-01. The U.S. Government maytherefore be entitled to certain rights in the invention.

BACKGROUND OF THE INVENTION

DNA Binds to Cell Membranes and is Internalized

In the 1970's, several investigators reported the binding of highmolecular weight DNA to cell membranes (Lerner, R. A., W. Meinke, and D.A. Goldstein. 1971. “Membrane-associated DNA in the cytoplasm of diploidhuman lymphocytes”. Proc. Natl. Acad. Sci. USA 68:1212; Agrawal, S. K.,R. W. Wagner, P. K. McAllister, and B. Rosenberg. 1975.“Cell-surface-associated nucleic acid in tumorigenic cells made visiblewith platinum-pyrimidine complexes by electron microscopy”. Proc. Natl.Acad. Sci. USA 72:928). In 1985, Bennett et al. presented the firstevidence that DNA binding to lymphocytes is similar to a ligand receptorinteraction: binding is saturable, competitive, and leads to DNAendocytosis and degradation into oligonucleotides (Bennett, R. M., G. T.Gabor, and M. M. Merritt. 1985. “DNA binding to human leukocytes.Evidence for a receptor-mediated association, internalization, anddegradation of DNA”. J. Clin. Invest. 76:2182). Like DNA,oligodeoxyribonucleotides (ODNs) are able to enter cells in a saturable,sequence independent, and temperature and energy dependent fashion(reviewed in Jaroszewski, J. W., and J. S. Cohen. 1991. “Cellular uptakeof antisense oligodeoxynucleotides”. Advanced Drug Delivery Reviews6:235; Akhtar, S., Y. Shoji, and R. L. Juliano. 1992. “Pharmaceuticalaspects of the biological stability and membrane transportcharacteristics of antisense oligonucleotides”. In: Gene Regulation:Biology of Antisense RNA and DNA. R. P. Erickson, and J. G. Izant, eds.Raven Press, Ltd. New York, pp. 133; and Zhao, Q., T. Waldschmidt, E.Fisher, C. J. Herrera, and A. M. Krieg., 1994. “Stage specificoligonucleotide uptake in murine bone marrow B cell precursors”. Blood,84:3660). No receptor for DNA or ODN uptake has yet been cloned, and itis not yet clear whether ODN binding and cell uptake occurs through thesame or a different mechanism from that of high molecular weight DNA.

Lymphocyte ODN uptake has been shown to be regulated by cell activation.Spleen cells stimulated with the B cell mitogen LPS had dramaticallyenhanced ODN uptake in the B cell population, while spleen cells treatedwith the T cell mitogen Con A showed enhanced ODN uptake by T but not Bcells (Krieg, A. M., F. Gmelig-Meyling, M. F. Gourley, W. J. Kisch, L.A. Chrisey, and A. D. Steinberg. 1991. “Uptake ofoligodeoxyribonucleotides by lymphoid cells is heterogeneous andinducible”. Antisense Research and Development 1:161).

Immune Effects of Nucleic Acids

Several polynucleotides have been extensively evaluated as biologicalresponse modifiers. Perhaps the best example is poly (I,C) which is apotent inducer of IFN production as well as a macrophage activator andinducer of NK activity (Talmadge, J. E., J. Adams, H. Phillips, M.Collins, B. Lenz, M. Schneider, E. Schlick, R. Ruffmann, R. H. Wiltrout,and M. A. Chirigos. 1985. “Immunomodulatory effects in mice ofpolyinosinic-polycytidylic acid complexed with poly-L-lysine andcarboxymethylcellulose”. Cancer Res. 45:1058; Wiltrout, R. H., R. R.Salup, T. A. Twilley, and J. E. Talmadge. 1985. “Immunomodulation ofnatural killer activity by polyribonucleotides”. J. Biol. Resp. Mod.4:512; Krown, S. E. 1986. “Interferons and interferon inducers in cancertreatment”. Sem. Oncol. 13:207; and Ewel, C. H., S. J. Urba, W. C. Kopp,J. W. Smith II, R. G. Steis, J. L. Rossio, D. L. Longo, M. J. Jones, W.G. Alvord, C. M. Pinsky, J. M. Beveridge, K. L. McNitt, and S. P.Creekmore. 1992. “Polyinosinic-polycytidylic acid complexed withpoly-L-lysine and carboxymethylcellulose in combination withinterleukin-2 in patients with cancer: clinical and immunologicaleffects”. Canc. Res. 52:3005). It appears that this murine NK activationmay be due solely to induction of IFN-β secretion (Ishikawa, R., and C.A. Biron. 1993. “IFN induction and associated changes in splenicleukocyte distribution”. J. Immunol. 150:3713). This activation wasspecific for the ribose sugar since deoxyribose was ineffective. Itspotent in vitro antitumor activity led to several clinical trials usingpoly (I,C) complexed with poly-L-lysine and carboxymethylcellulose (toreduce degradation by RNAse) (Talmadge, J. E., et al., 1985. citedsupra; Wiltrout, R. H., et al., 1985. cited supra); Krown, S. E., 1986.cited supra); and Ewel, C. H., et al., 1992. cited supra).Unfortunately, toxic side effects have thus far prevented poly (I,C)from becoming a useful therapeutic agent.

Guanine ribonucleotides substituted at the C8 position with either abromine or a thiol group are B cell mitogens and may replace “B celldifferentiation factors” (Feldbush, T. L., and Z. K. Ballas. 1985.“Lymphokine-like activity of 8-mercaptoguanosine: induction of T and Bcell differentiation”. J. Immunol. 134:3204; and Goodman, M. G. 1986.“Mechanism of synergy between T cell signals and C8-substituted guaninenucleosides in humoral immunity: B lymphotropic cytokines induceresponsiveness to 8-mercaptoguanosine”. J. Immunol. 136:3335).8-mercaptoguanosine and 8-bromoguanosine also can substitute for thecytokine requirement for the generation of MHC restricted CTL (Feldbush,T. L., 1985. cited supra), augment murine NK activity (Koo, G. C., M. E.Jewell, C. L. Manyak, N. H. Sigal, and L. S. Wicker. 1988. “Activationof murine natural killer cells and macrophages by 8-bromoguanosine”. J.Immunol. 140:3249), and synergize with IL-2 in inducing murine LAKgeneration (Thompson, R. A., and Z. K. Ballas. 1990.“Lymphokine-activated killer (LAK) cells. V. 8-Mercaptoguanosine as anIL-2-sparing agent in LAK generation”. J. Immunol. 145:3524). The NK andLAK augmenting activities of these C8-substituted guanosines appear tobe due to their induction of IFN (Thompson, R. A., et al. 1990. citedsupra). Recently, a 5′ triphosphorylated thymidine produced by amycobacterium was found to be mitogenic for a subset of human γδ T cells(Constant, P., F. Davodeau, M.-A. Peyrat, Y. Poquet, G. Puzo, M.Bonneville, and J.-J. Fournie. 1994. “Stimulation of human γδ T cells bynonpeptidic mycobacterial ligands” Science 264:267). This reportindicated the possibility that the immune system may have evolved waysto preferentially respond to microbial nucleic acids.

Several observations suggest that certain DNA structures may also havethe potential to activate lymphocytes. For example, Bell et al. reportedthat nucleosomal protein-DNA complexes (but not naked DNA) in spleencell supernatants caused B cell proliferation and immunoglobulinsecretion (Bell, D. A., B. Morrison, and P. VandenBygaart. 1990.“Immunogenic DNA-related factors”. J. Clin. Invest. 85:1487). In othercases, naked DNA has been reported to have immune effects. For example,Messina et al. have recently reported that 260 to 800 bp fragments ofpoly (dG)•(dC) and poly (dG•dC) were mitogenic for B cells (Messina, J.P., G. S. Gilkeson, and D. S. Pisetsky. 1993. “The influence of DNAstructure on the in vitro stimulation of murine lymphocytes by naturaland synthetic polynucleotide antigens”. Cell. Immunol. 147:148).Tokunaga, et al. have reported that dG•dC induces IFN-γ and NK activity(Tokunaga, S. Yamamoto, and K. Namba. 1988. “A synthetic single-strandedDNA, poly(dG,dC), induces interferon-α/β and -γ, augments natural killeractivity, and suppresses tumor growth” Jpn. J. Cancer Res. 79:682).Aside from such artificial homopolymer sequences, Pisetsky et al.reported that pure mammalian DNA has no detectable immune effects, butthat DNA from certain bacteria induces B cell activation andimmunoglobulin secretion (Messina, J. P., G. S. Gilkeson, and D. S.Pisetsky. 1991. “Stimulation of in vitro murine lymphocyte proliferationby bacterial DNA”. J. Immunol. 147:1759). Assuming that these data didnot result from some unusual contaminant, these studies suggested that aparticular structure or other characteristic of bacterial DNA renders itcapable of triggering B cell activation. Investigations of mycobacterialDNA sequences have demonstrated that ODN which contain certainpalindrome sequences can activate NK cells (Yamamoto, S., T. Yamamoto,T. Kataoka, E. Kuramoto, O. Yano, and T. Tokunaga. 1992. “Uniquepalindromic sequences in synthetic oligonucleotides are required toinduce INF and augment INF-mediated natural killer activity”. J.Immunol. 148:4072; Kuramoto, E., O. Yano, Y. Kimura, M. Baba, T. Makino,S. Yamamoto, T. Yamamoto, T. Kataoka, and T. Tokunaga. 1992.“Oligonucleotide sequences required for natural killer cell activation”.Jpn. J. Cancer Res. 83:1128).

Several phosphorothioate modified ODN have been reported to induce invitro or in vivo B cell stimulation (Tanaka, T., C. C. Chu, and W. E.Paul. 1992. “An antisense oligonucleotide complementary to a sequence inIγ2b increases γ2b germline transcripts, stimulates B cell DNAsynthesis, and inhibits immunoglobulin secretion”. J. Exp. Med. 175:597;Branda, R. F., A. L. Moore, L. Mathews, J. J. McCormack, and G. Zon.1993. “Immune stimulation by an antisense oligomer complementary to therev gene of HIV-1”. Biochem. Pharmacol. 45:2037; McIntyre, K. W., K.Lombard-Gillooly, J. R. Perez, C. Kunsch, U. M. Sarmiento, J. D.Larigan, K. T. Landreth, and R. Narayanan. 1993. “A sensephosphorothioate oligonucleotide directed to the initiation codon oftranscription factor NFκB T65 causes sequence-specific immunestimulation”. Antisense Res. Develop. 3:309; and Pisetsky, D. S., and C.F. Reich. 1993. “Stimulation of murine lymphocyte proliferation by aphosphorothioate oligonucleotide with antisense activity for herpessimplex virus”. Life Sciences 54:101). These reports do not suggest acommon structural motif or sequence element in these ODN that mightexplain their effects.

The CREB/ATF Family of Transcription Factors and their Role inReplication

The cAMP response element binding protein (CREB) and activatingtranscription factor (ATF) or CREB/ATF family of transcription factorsis a ubiquitously expressed class of transcription factors of which 11members have so far been cloned (reviewed in de Groot, R. P., and P.Sassone-Corsi: “Hormonal control of gene expression: Multiplicity andversatility of cyclic adenosine 3′,5′-monophosphate-responsive nuclearregulators”. Mol. Endocrin. 7:145, 1993; Lee, K. A. W., and N. Masson:“Transcriptional regulation by CREB and its relatives”. Biochim.Biophys. Acta 1174:221, 1993). They all belong to the basicregion/leucine zipper (bZip) class of proteins. All cells appear toexpress one or more CREB/ATF proteins, but the members expressed and theregulation of mRNA splicing appear to be tissue-specific. Differentialsplicing of activation domains can determine whether a particularCREB/ATF protein will be a transcriptional inhibitor or activator. ManyCREB/ATF proteins activate viral transcription, but some splicingvariants which lack the activation domain are inhibitory. CREB/ATFproteins can bind DNA as homo- or hetero-dimers through the cAMPresponse element, the CRE, the consensus form of which is theunmethylated sequence TGACGTC (binding is abolished if the CpG ismethylated) (Iguchi-Ariga, S. M. M., and W. Schaffner: “CpG methylationof the cAMP-responsive enhancer/promoter sequence TGACGTCA abolishesspecific factor binding as well as transcriptional activation”. Genes &Develop. 3:612, 1989).

The transcriptional activity of the CRE is increased during B cellactivation (Xie, H. T. C. Chiles, and T. L. Rothstein: “Induction ofCREB activity via the surface Ig receptor of B cells”. J. Immunol.151:880, 1993). CREB/ATF proteins appear to regulate the expression ofmultiple genes through the CRE including immunologically important genessuch as fos, jun B, Rb-1, IL-6, IL-1 (Tsukada, J., K. Saito, W. R.Waterman, A. C. Webb, and P. E. Auron: “Transcription factors NF-IL6 andCREB recognize a common essential site in the human prointerleukin 1βgene”. Mol. Cell. Biol. 14:7285, 1994; Gray, G. D., O. M. Hernandez, D.Hebel, M. Root, J. M. Pow-Sang, and E. Wickstrom: “Antisense DNAinhibition of tumor growth induced by c-Ha-ras oncogene in nude mice”.Cancer Res. 53:577, 1993), IFN-β (Du, W., and T. Maniatis: “An ATF/CREBbinding site protein is required for virus induction of the humaninterferon B gene”. Proc. Natl. Acad. Sci. USA 89:2150, 1992), TGF-β1(Asiedu, C. K., L. Scott, R. K. Assoian, M. Ehrlich: “Binding ofAP-1/CREB proteins and of MDBP to contiguous sites downstream of thehuman TGF-B1 gene”. Biochim. Biophys. Acta 1219:55, 1994), TGF-β2, classII MHC (Cox, P. M., and C. R. Goding: “An ATF/CREB binding motif isrequired for aberrant constitutive expression of the MHC class II DRapromoter and activation by SV40 T-antigen”. Nucl. Acids Res. 20:4881,1992), E-selectin, GM-CSF, CD-8α, the germline Iga constant region gene,the TCR Vβ gene, and the proliferating cell nuclear antigen (Huang, D.,P. M. Shipman-Appasamy, D. J. Orten, S. H. Hinrichs, and M. B.Prystowsky: “Promoter activity of the proliferating-cell nuclear antigengene is associated with inducible CRE-binding proteins in interleukin2-stimulated T lymphocytes”. Mol. Cell. Biol. 14:4233, 1994). Inaddition to activation through the cAMP pathway, CREB can also mediatetranscriptional responses to changes in intracellular Ca⁺⁺ concentration(Sheng, M., G. McFadden, and M. E. Greenberg: “Membrane depolarizationand calcium induce c-fos transcription via phosphorylation oftranscription factor CREB”. Neuron 4:571, 1990).

The role of protein-protein interactions in transcriptional activationby CREB/ATF proteins appears to be extremely important. There areseveral published studies reporting direct or indirect interactionsbetween NFKB proteins and CREB/ATF proteins (Whitley, et. al., (1994)Mol. & Cell. Biol 14:6464; Cogswell, et al., (1994) J. Immun. 153:712;Hines, et al., (1993) Oncogene 8:3189; and Du, et al., (1993) Cell74:887. Activation of CREB through the cyclic AMP pathway requiresprotein kinase A (PKA), which phosphorylates CREB³⁴¹ on ser¹³³ andallows it to bind to a recently cloned protein, CBP (Kwok, R. P. S., J.R. Lundblad, J. C. Chrivia, J. P. Richards, H. P. Bachinger, R. G.Brennan, S. G. E. Roberts, M. R. Green, and R. H. Goodman: “Nuclearprotein CBP is a coactivator for the transcription factor CREB”. Nature370:223, 1994; Arias, J., A. S. Alberts, P. Brindle, F. X. Claret, T.Smea, M. Karin, J. Feramisco, and M. Montminy: “Activation of cAMP andmitogen responsive genes relies on a common nuclear factor”. Nature370:226, 1994). CBP in turn interacts with the basal transcriptionfactor TFIIB causing increased transcription. CREB also has beenreported to interact with dTAFII 110, a TATA binding protein-associatedfactor whose binding may regulate transcription (Ferreri, K., G. Gill,and M. Montminy: “The cAMP-regulated transcription factor CREB interactswith a component of the TFIID complex”. Proc. Natl. Acad. Sci. USA91:1210, 1994). In addition to these interactions, CREB/ATF proteins canspecifically bind multiple other nuclear factors (Hoeffler, J. P., J. W.Lustbader, and C.-Y. Chen: “Identification of multiple nuclear factorsthat interact with cyclic adenosine 3′,5′-monophosphate responseelement-binding protein and activating transcription factor-2 byprotein-protein interactions”. Mol. Endocrinol. 5:256, 1991) but thebiologic significance of most of these interactions is unknown. CREB isnormally thought to bind DNA either as a homodimer or as a heterodimerwith several other proteins. Surprisingly, CREB monomers constitutivelyactivate transcription (Krajewski, W., and K. A. W. Lee: “A monomericderivative of the cellular transcription factor CREB functions as aconstitutive activator”. Mol. Cell. Biol. 14:7204, 1994).

Aside from their critical role in regulating cellular transcription, ithas recently been shown that CREB/ATF proteins are subverted by someinfectious viruses and retroviruses, which require them for viralreplication. For example, the cytomegalovirus immediate early promoter,one of the strongest known mammalian promoters, contains eleven copiesof the CRE which are essential for promoter function (Chang, Y.-N., S.Crawford, J. Stall, D. R. Rawlins, K.-T. Jeang, and G. S. Hayward: “Thepalindromic series I repeats in the simian cytomegalovirus majorimmediate-early promoter behave as both strong basal enhancers andcyclic AMP response elements”. J. Virol. 64:264, 1990). At least some ofthe transcriptional activating effects of the adenovirus E1A protein,which induces many promoters, are due to its binding to the DNA bindingdomain of the CREB/ATF protein, ATF-2, which mediates E1A inducibletranscription activation (Liu, F., and M. R. Green: “Promoter targetingby adenovirus E1a through interaction with different cellularDNA-binding domains”. Nature 368:520, 1994). It has also been suggestedthat E1A binds to the CREB-binding protein, CBP (Arany, Z., W. R.Sellers, D. M. Livingston, and R. Eckner: “E1A-associated p300 andCREB-associated CBP belong to a conserved family of coactivators”. Cell77:799, 1994). Human T lymphotropic virus-I (HTLV-1), the retroviruswhich causes human T cell leukemia and tropical spastic paresis, alsorequires CREB/ATF proteins for replication. In this case, the retrovirusproduces a protein, Tax, which binds to CREB/ATF proteins and redirectsthem from their normal cellular binding sites to different DNA sequences(flanked by G- and C-rich sequences) present within the HTLVtranscriptional enhancer (Paca-Uccaralertkun, S., L.-J. Zhao, N. Adya,J. V. Cross, B. R. Cullen, I. M. Boros, and C.-Z. Giam: “In vitroselection of DNA elements highly responsive to the human T-celllymphotropic virus type I transcriptional activator, Tax”. Mol. Cell.Biol. 14:456, 1994; Adya, N., L.-J. Zhao, W. Huang, I. Boros, and C.-Z.Giam: “Expansion of CREB's DNA recognition specificity by Tax resultsfrom interaction with Ala-Ala-Arg at positions 282-284 near theconserved DNA-binding domain of CREB”. Proc. Natl. Acad. Sci. USA91:5642, 1994).

SUMMARY OF THE INVENTION

The instant invention is based on the finding that certain nucleic acidscontaining unmethylated cytosine-guanine (CpG) dinucleotides activatelymphocytes in a subject and redirect a subject's immune response from aTh2 to a Th1 (e.g. by inducing monocytic cells and other cells toproduce Th1 cytokines, including IL-12, IFN-γ and GM-CSF). Based on thisfinding, the invention features, in one aspect, novel immunostimulatorynucleic acid compositions.

In a preferred embodiment, the immunostimulatory nucleic acid contains aconsensus mitogenic CpG motif represented by the formula:

5′ X₁CGX₂ 3′

wherein X₁ is selected from the group consisting of A, G and T; and X₂is C or T.

In a particularly preferred embodiment an immunostimulatory nucleic acidmolecule contains a consensus mitogenic CpG motif represented by theformula:

5′ X₁X₂CGX₃X₄ 3′

wherein C and G are unmethylated; and X₁, X₂, X₃ and X₄ are nucleotides.

Enhanced immunostimulatory activity of human cells occurs where X₁X₂ isselected from the group consisting of GpT, GpG, GpA and ApA and/or X₃X₄is selected from the group consisting of TpT, CpT and GPT (Table 5). Forfacilitating uptake into cells, CpG containing immunostimulatory nucleicacid molecules are preferably in the range of 8 to 40 base pairs insize. However, nucleic acids of any size (even many kb long) areimmunostimulatory if sufficient immunostimulatory motifs are present,since such larger nucleic acids are degraded into oligonucleotidesinside of cells. Preferred synthetic oligonucleotides do not include aGCG trinucleotide sequence at or near the 5′ and/or 3′ terminals and/orthe consensus mitogenic CpG motif is not a palindrome. Prolongedimmunostimulation can be obtained using stabilized oligonucleotides,particularly phosphorothioate stabilized oligonucleotides.

In a second aspect, the invention features useful therapies, which arebased on the immunostimulatory activity of the nucleic acid molecules.For example, the immunostimulatory nucleic acid molecules can be used totreat, prevent or ameliorate an immune system deficiency (e.g., a tumoror cancer or a viral, fungal, bacterial or parasitic infection in asubject). In addition, immunostimulatory nucleic acid molecules can beadministered to stimulate a subject's response to a vaccine.

Further, by redirecting a subject's immune response from Th2 to Th1, theinstant claimed nucleic acid molecules can be administered to treat orprevent the symptoms of asthma. In addition, the instant claimed nucleicacid molecules can be administered in conjunction with a particularallergen to a subject as a type of desensitization therapy to treat orprevent the occurrence of an allergic reaction.

Further, the ability of immunostimulatory nucleic acid molecules toinduce leukemic cells to enter the cell cycle supports the use ofimmunostimulatory nucleic acid molecules in treating leukemia byincreasing the sensitivity of chronic leukemia cells and thenadministering conventional ablative chemotherapy, or combining theimmunostimulatory nucleic acid molecules with another immunotherapy.

Other features and advantages of the invention will become more apparentfrom the following detailed description and claims.

BRIEF DESCRIPTION OF THE FIGURES

FIG. 1A-C are graphs plotting dose-dependent IL-6 production in responseto various DNA sequences in T cell depleted spleen cell cultures. A. E.coli DNA (●) and calf thymus DNA (▪) sequences and LPS (at 10× theconcentration of E. coli and calf thymus DNA) (♦). B. Controlphosphodiester oligodeoxynucleotide (ODN) ^(5′)ATGGAAGGTCCAGTGTTCTC^(3′)(SEQ ID NO:1) (▪) and two phosphodiester CpG ODN^(5′)ATCGACCTACGTGCGTTCTC^(3′) (SEQ ID NO:2) (♦) and^(5′)TCCATAACGTTCCTGATGCT^(3′) (SEQ ID NO:3) (●). C. Controlphosphorothioate ODN ^(5′)GCTAGATGTTAGCGT^(3′) (SEQ ID NO:4) (▪) and twophosphorothioate CpG ODN ^(5′)GAGAACGTCGACCTTCGAT^(3′) (SEQ ID NO:5) (♦)and ^(5′)GCATGACGTTGAGCT^(3′) (SEQ ID NO:6) (●). Data present themean±standard deviation of triplicates.

FIG. 2 is a graph plotting IL-6 production induced by CpG DNA in vivo asdetermined 1-8 hrs after injection. Data represent the mean fromduplicate analyses of sera from two mice. BALB/c mice (two mice/group)were injected iv. with 100 μl of PBS (□) or 200 μg of CpGphosphorothioate ODN 5′TCCATGACGTTCCTGATGCT 3′ (SEQ ID NO:7) (▪) ornon-CpG phosphorothioate ODN 5′TCCATGAGCTTCCTGAGTCT 3′ (SEQ ID NO:8)(♦).

FIG. 3 is an autoradiograph showing IL-6 mRNA expression as determinedby reverse transcription polymerase chain reaction in liver, spleen, andthymus at various time periods after in vivo stimulation of BALB/c mice(two mice/group) injected iv with 100 μl of PBS, 200 μg of CpGphosphorothioate ODN 5′TCCATGACGTTCCTGATGCT 3′ (SEQ ID NO:7) or non-CpGphosphorothioate ODN 5′TCCATGAGCTTCCTGAGTCT 3′ (SEQ ID NO:8).

FIG. 4A is a graph plotting dose-dependent inhibition of CpG-induced IgMproduction by anti-IL-6. Splenic B-cells from DBA/2 mice were stimulatedwith CpG ODN ^(5′)TCCAAGACGTTCCTGATGCT³ (SEQ ID NO:9) in the presence ofthe indicated concentrations of neutralizing anti-IL-6 (♦) or isotypecontrol Ab (●) and IgM levels in culture supernatants determined byELISA. In the absence of CpG ODN, the anti-IL-6 Ab had no effect on IgMsecretion (▪).

FIG. 4B is a graph plotting the stimulation index of CpG-induced splenicB cells cultured with anti-IL-6 and CpG S-ODN 5′TCCATGACGTTCCTGATGCT 3′(SEQ ID NO:7) (♦) or anti-IL-6 antibody only (▪). Data present themean±standard deviation of triplicates.

FIG. 5 is a bar graph plotting chloramphenicol acetyltransferase (CAT)activity in WEHI-231 cells transfected with a promoter-less CATconstruct (pCAT), positive control plasmid (RSV), or IL-6 promoter-CATconstruct alone or cultured with CpG 5′TCCATGACGTTCCTGATGCT 3′ (SEQ IDNO:7) or non-CpG 5′TCCATGAGCTTCCTGAGTCT 3′ (SEQ ID NO:8)phosphorothioate ODN at the indicated concentrations. Data present themean of triplicates.

FIG. 6 is a schematic overview of the immune effects of theimmunostimulatory unmethylated CpG containing nucleic acids, which candirectly activate both B cells and monocytic cells (includingmacrophages and dendritic cells) as shown. The immunostimulatoryoligonucleotides do not directly activate purified NK cells, but renderthem competent to respond to IL-12 with a marked increase in their IFN-γproduction. By inducing IL-12 production and the subsequent increasedIFN-γ secretion by NK cells, the immunostimulatory nucleic acids promotea Th1 type immune response. No direct activation of proliferation ofcytokine secretion by highly purified T cells has been found. However,the induction of Th1 cytokine secretion by the immunostimulatoryoligonucleotides promotes the development of a cytotoxic lymphocyteresponse.

FIG. 7 is an autoradiograph showing NFκB mRNA induction in monocytestreated with E. coli (EC) DNA (containing unmethylated CpG motifs),control (CT) DNA (containing no unmethylated CpG motifs) andlipopolysaccharide (LPS) at various measured times, 15 and 30 minutesafter contact.

FIG. 8A shows the results from a flow cytometry study using mouse Bcells with the dihydrorhodamine 123 dye to determine levels of reactiveoxygen species. The dye only sample in Panel A of the figure shows thebackground level of cells positive for the dye at 28.6%. This level ofreactive oxygen species was greatly increased to 80% in the cellstreated for 20 minutes with PMA and ionomycin, a positive control (PanelB). The cells treated with the CpG oligo (TCCATGACGTTCCTGACGTT SEQ IDNO:10) also showed an increase in the level of reactive oxygen speciessuch that more than 50% of the cells became positive (Panel D). However,cells treated with an oligonucleotide with the identical sequence exceptthat the CpGs were switched (TCCATGAGCTTCCTGAGTGCT SEQ ID NO:11) did notshow this significant increase in the level of reactive oxygen species(Panel E).

FIG. 8B shows the results from a flow cytometry study using mouse Bcells in the presence of chloroquine with the dihydrorhodamine 123 dyeto determine levels of reactive oxygen species. Chloroquine slightlylowers the background level of reactive oxygen species in the cells suchthat the untreated cells in Panel A have only 4.3% that are positive.Chloroquine completely abolishes the induction of reactive oxygenspecies in the cells treated with CpG DNA (Panel B) but does not reducethe level of reactive oxygen species in the cells treated with PMA andionomycin (Panel E).

FIG. 9 is a graph plotting lung lavage cell count over time. The graphshows that when the mice are initially injected with Schistosoma mansonieggs “egg”, which induces a Th2 immune response, and subsequently inhaleSchistosoma mansoni egg antigen “SEA” (open circle), many inflammatorycells are present in the lungs. However, when the mice are initiallygiven CpG oligo (SEQ ID NO:10) along with egg, the inflammatory cells inthe lung are not increased by subsequent inhalation of SEA (opentriangles).

FIG. 10 is a graph plotting lung lavage eosinophil count over time.Again, the graph shows that when the mice are initially injected withegg and subsequently inhale SEA (open circle), many eosinophils arepresent in the lungs. However, when the mice are initially given CpGoligo (SEQ ID NO:10) along with egg, the inflammatory cells in the lungare not increased by subsequent inhalation of the SEA (open triangles).

FIG. 11 is a bar graph plotting the effect on the percentage ofmacrophage, lymphocyte, neutrophil and eosinophil cells induced byexposure to saline alone; egg, then SEA; egg and SEQ ID NO:11, then SEA;and egg and control oligo (SEQ ID NO:11), then SEA. When the mice aretreated with the control oligo at the time of the initial exposure tothe egg, there is little effect on the subsequent influx of eosinophilsinto the lungs after inhalation of SEA. Thus, when mice inhale the eggson days 14 or 21, they develop an acute inflammatory response in thelungs. However, giving a CpG oligo along with the eggs at the time ofinitial antigen exposure on days 0 and 7 almost completely abolishes theincrease in eosinophils when the mice inhale the egg antigen on day 14.

FIG. 12 is a bar graph plotting eosinophil count in response toinjection of various amounts of the protective oligo SEQ ID NO:10.

FIG. 13 is a graph plotting interleukin 4 (IL-4) production (pg/ml) inmice over time in response to injection of egg, then SEA (open diamond);egg and SEQ ID NO: 10, then SEA (open circle); or saline, then saline(open square). The graph shows that the resultant inflammatory responsecorrelates with the levels of the Th2 cytokine IL-4 in the lung.

FIG. 14 is a bar graph plotting interleukin 12 (IL-12) production(pg/ml) in mice over time in response to injection of saline; egg, thenSEA; or SEQ ID NO: 10 and egg, then SEA. The graph shows thatadministration of an oligonucleotide containing an unmethylated CpGmotif can actually redirect the cytokine response of the lung toproduction of IL-12, indicating a Th1 type of immune response.

FIG. 15 is a bar graph plotting interferon gamma (IFN-γ) production(pg/ml) in mice over time in response to injection of saline; egg, thensaline; or SEQ ID NO:10 and egg, then SEA. The graph shows thatadministration of an oligonucleotide containing an unmethylated CpGmotif can also redirect the cytokine response of the lung to productionof IFN-γ, indicating a Th1 type of immune response.

DETAILED DESCRIPTION OF THE INVENTION Definitions

As used herein, the following terms and phrases shall have the meaningsset forth below:

An “allergen” refers to a substance that can induce an allergic orasthmatic response in a susceptible subject. The list of allergens isenormous and can include pollens, insect venoms, animal dander, dust,fungal spores and drugs (e.g. penicillin). Examples of natural, animaland plant allergens include proteins specific to the following genera:Canine (Canis familiaris); Dermatophagoides (e.g. Dermatophagoidesfarinae); Felis (Felis domesticus); Ambrosia (Ambrosia artemiisfolia;Lolium (e.g. Lolium perenne or Lolium multiflorum); Cryptomeria(Cryptomeria japonica); Alternaria (Alternaria alternata); Alder; Alnus(Alnus gultinosa); Betula (Betula verrucosa); Quercus (Quercus alba);Olea (Olea europa); Artemisia (Artemisia vulgaris); Plantago (e.g.Plantago lanceolata); Parietaria (e.g. Parietaria officinalis orParietaria judaica); Blattella (e.g. Blattella germanica); Apis (e.g.Apis multiflorum); Cupressus (e.g. Cupressus sempervirens, Cupressusarizonica and Cupressus macrocarpa); Juniperus (e.g. Juniperussabinoides, Juniperus virginiana, Juniperus communis and Juniperusashei); Thuya (e.g. Thuya orientalis); Chamaecyparis (e.g. Chamaecyparisobtusa); Periplaneta (e.g. Periplaneta americana); Agropyron (e.g.Agropyron repens); Secale (e.g. Secale cereale); Triticum (e.g. Triticumaestivum); Dactylis (e.g. Dactylis glomerata); Festuca (e.g. Festucaelatior); Poa (e.g. Poa pratensis or Poa compressa); Avena (e.g. Avenasativa); Holcus (e.g. Holcus lanatus); Anthoxanthum (e.g. Anthoxanthumodoratum); Arrhenatherum (e.g. Arrhenatherum elatius); Agrostis (e.g.Agrostis alba); Phleum (e.g. Phleum pratense); Phalaris (e.g. Phalarisarundinacea); Paspalum (e.g. Paspalum notatum); Sorghum (e.g. Sorghumhalepensis); and Bromus (e.g. Bromus inermis).

An “allergy” refers to acquired hypersensitivity to a substance(allergen). Allergic conditions include eczema, allergic rhinitis orcoryza, hay fever, bronchial asthma, urticaria (hives) and foodallergies, and other atopic conditions.

“Asthma”—refers to a disorder of the respiratory system characterized byinflammation, narrowing of the airways and increased reactivity of theairways to inhaled agents. Asthma is frequently, although notexclusively associated with atopic or allergic symptoms.

An “immune system deficiency” shall mean a disease or disorder in whichthe subject's immune system is not functioning in normal capacity or inwhich it would be useful to boost a subject's immune response forexample to eliminate a tumor or cancer (e.g. tumors of the brain, lung(e.g. small cell and non-small cell), ovary, breast, prostate, colon, aswell as other carcinomas and sarcomas) or an infection in a subject.

Examples of infectious virus include: Retroviridae (e.g., humanimmunodeficiency viruses, such as HIV-1 (also referred to as HTLV-III,LAV or HTLV-III/LAV, or HIV-III; and other isolates, such as HIV-LP;Picornaviridae (e.g., polio viruses, hepatitis A virus; enteroviruses,human coxsackie viruses, rhinoviruses, echoviruses); Calciviridae (e.g.,strains that cause gastroenteritis); Togaviridae (e.g., equineencephalitis viruses, rubella viruses); Flaviridae (e.g., dengueviruses, encephalitis viruses, yellow fever viruses); Coronaviridae(e.g., coronaviruses); Rhabdoviridae (e.g., vesicular stomatitisviruses, rabies viruses); Filoviridae (e.g., ebola viruses);Paramyxoviridae (e.g., parainfluenza viruses, mumps virus, measlesvirus, respiratory syncytial virus); Orthomyxoviridae (e.g., influenzaviruses); Bungaviridae (e.g., Hantaan viruses, bunga viruses,phleboviruses and Nairo viruses); Arena viridae (hemorrhagic feverviruses); Reoviridae (e.g., reoviruses, orbiviurses and rotaviruses);Birnaviridae; Hepadnaviridae (Hepatitis B virus); Parvoviridae(parvoviruses); Papovaviridae (papilloma viruses, polyoma viruses);Adenoviridae (most adenoviruses); Herpesviridae (herpes simplex virus(HSV) 1 and 2, varicella zoster virus, cytomegalovirus (CMV), herpesviruses'); Poxviridae (variola viruses, vaccinia viruses, pox viruses);and Iridoviridae (e.g., African swine fever virus); and unclassifiedviruses (e.g., the etiological agents of Spongiform encephalopathies,the agent of delta hepatitis (thought to be a defective satellite ofhepatitis B virus), the agents of non-A, non-B hepatitis (class1=internally transmitted; class 2=parenterally transmitted (i.e.,Hepatitis C); Norwalk and related viruses, and astroviruses).

Examples of infectious bacteria include: Helicobacterpyloris, Boreliaburgdorferi, Legionella pneumophilia, Mycobacteria spp. (e.g., M.tuberculosis, M. avium, M intracellulare, M. kansasii, M. gordonae),Staphylococcus aureus, Neisseria gonorrhoeae, Neisseria meningitidis,Listeria monocytogenes, Streptococcus pyogenes (Group A Streptococcus),Streptococcus agalactiae (Group B Streptococcus), Streptococcus(viridans group), Streptococcus faecalis, Streptococcus bovis,Streptococcus (anaerobic spp.), Streptococcus pneumoniae, pathogenicCampylobacter sp., Enterococcus sp., Haemophilus influenzae, Bacillusanthracis, Corynebacterium diphtheriae, Corynebacterium sp.,Erysipelothrix rhusiopathiae, Clostridium perfringens, Clostridiumtetani, Enterobacter aerogenes, Klebsiella pneumoniae, Pasturellamultocida, Bacteroides sp., Fusobacterium nucleatum, Streptobacillusmoniliformis, Treponema pallidum, Treponema pertenue, Leptospira, andActinomyces israelli.

Examples of infectious fungi include: Cryptococcus neoformans,Histoplasma capsulatum, Coccidioides immitis, Blastomyces dermatitidis,Chlamydia trachomatis, Candida albicans. Other infectious organisms(i.e., protists) include: Plasmodium falciparum and Toxoplasma gondii.

An “immunostimulatory nucleic acid molecule” refers to a nucleic acidmolecule, which contains an unmethylated cytosine, guanine dinucleotidesequence (i.e. “CpG DNA” or DNA containing a cytosine followed byguanosine and linked by a phosphate bond) and stimulates (e.g. has amitogenic effect on, or induces or increases cytokine expression by) avertebrate lymphocyte. An immunostimulatory nucleic acid molecule can bedouble-stranded or single-stranded. Generally, double-stranded moleculesare more stable in vivo, while single-stranded molecules have increasedimmune activity.

In a preferred embodiment, the immunostimulatory nucleic acid contains aconsensus mitogenic CpG motif represented by the formula:

5′ X₁CGX₂ 3′

wherein X₁ is selected from the group consisting of A, G and T; and X₂is C or T.

In a particularly preferred embodiment, immunostimulatory nucleic acidmolecules are between 2 to 100 base pairs in size and contain aconsensus mitogenic CpG motif represented by the formula:

5′ X₁X₂CGX₃X₄ 3′

wherein C and G are unmethylated, X₁, X₂, X₃ and X₄ are nucleotides.

For economic reasons, preferably the immunostimulatory CpG DNA is in therange of between 8 to 40 base pairs in size if it is synthesized as anoligonucleotide. Alternatively, CpG dinucleotides can be produced on alarge scale in plasmids, which after being administered to a subject aredegraded into oligonucleotides. Preferred immunostimulatory nucleic acidmolecules (e.g. for use in increasing the effectiveness of a vaccine orto treat an immune system deficiency by stimulating an antibody[humoral] response in a subject) have a relatively high stimulationindex with regard to B cell, monocyte and/or natural killer cellresponses (e.g. cytokine, proliferative, lytic or other responses).

The stimulation index of a particular immunostimulatory CpG DNA can betested in various immune cell assays. Preferably, the stimulation indexof the immunostimulatory CpG DNA with regard to B-cell proliferation isat least about 5, preferably at least about 10, more preferably at leastabout 15 and most preferably at least about 20 as determined byincorporation of ³H uridine in a murine B cell culture, which has beencontacted with a 20 μM of ODN for 20 h at 37° C. and has been pulsedwith 1 μCi of ³H uridine; and harvested and counted 4 h later asdescribed in detail in Example 1. For use in vivo, for example to treatan immune system deficiency by stimulating a cell-mediated (local)immune response in a subject, it is important that the immunostimulatoryCpG DNA be capable of effectively inducing cytokine secretion bymonocytic cells and/or Natural Killer (NK) cell lytic activity.

Preferred immunostimulatory CpG nucleic acids should effect at leastabout 500 pg/ml of TNF-α, 15 pg/ml IFN-γ, 70 pg/ml of GM-CSF 275 pg/mlof IL-6, 200 pg/ml IL-12, depending on the therapeutic indication, asdetermined by the assays described in Example 12. Other preferredimmunostimulatory CpG DNAs should effect at least about 10%, morepreferably at least about 15% and most preferably at least about 20%YAC-1 cell specific lysis or at least about 30, more preferably at leastabout 35 and most preferably at least about 40% 2C11 cell specific lysisas determined by the assay described in detail in Example 4.

A “nucleic acid” or “DNA” shall mean multiple nucleotides (i.e.molecules comprising a sugar (e.g. ribose or deoxyribose) linked to aphosphate group and to an exchangeable organic base, which is either asubstituted pyrimidine (e.g. cytosine (C), thymine (T) or uracil (U)) ora substituted purine (e.g. adenine (A) or guanine (G)). As used herein,the term refers to ribonucleotides as well as oligodeoxyribonucleotides.The term shall also include polynucleosides (i.e. a polynucleotide minusthe phosphate) and any other organic base containing polymer. Nucleicacid molecules can be obtained from existing nucleic acid sources (e.g.genomic or cDNA), but are preferably synthetic (e.g. produced byoligonucleotide synthesis).

A “nucleic acid delivery complex” shall mean a nucleic acid moleculeassociated with (e.g. ionically or covalently bound to; or encapsulatedwithin) a targeting means (e.g. a molecule that results in higheraffinity binding to target cell (e.g. B-cell and natural killer (NK)cell) surfaces and/or increased cellular uptake by target cells).Examples of nucleic acid delivery complexes include nucleic acidsassociated with: a sterol (e.g. cholesterol), a lipid (e.g. a cationiclipid, virosome or liposome), or a target cell specific binding agent(e.g. a ligand recognized by target cell specific receptor). Preferredcomplexes must be sufficiently stable in vivo to prevent significantuncoupling prior to internalization by the target cell. However, thecomplex should be cleavable under appropriate conditions within the cellso that the nucleic acid is released in a functional form.

“Palindromic sequence” shall mean an inverted repeat (i.e. a sequencesuch as ABCDEE′D′C′B′A′ in which A and A′ are bases capable of formingthe usual Watson-Crick base pairs. In vivo, such sequences may formdouble stranded structures.

A “stabilized nucleic acid molecule” shall mean a nucleic acid moleculethat is relatively resistant to in vivo degradation (e.g. via an exo- orendo-nuclease). Stabilization can be a function of length or secondarystructure. Unmethylated CpG containing nucleic acid molecules that aretens to hundreds of kbs long are relatively resistant to in vivodegradation. For shorter immunostimulatory nucleic acid molecules,secondary structure can stabilize and increase their effect. Forexample, if the 3′ end of a nucleic acid molecule hasself-complementarity to an upstream region, so that it can fold back andform a sort of stem loop structure, then the nucleic acid moleculebecomes stabilized and therefore exhibits more activity.

Preferred stabilized nucleic acid molecules of the instant inventionhave a modified backbone. For use in immune stimulation, especiallypreferred stabilized nucleic acid molecules are phosphorothioatemodified nucleic acid molecules (i.e. at least one of the phosphateoxygens of the nucleic acid molecule is replaced by sulfur). Preferablythe phosphate modification occurs at or near the 5′ and/or 3′ end of thenucleic acid molecule. In addition to stabilizing nucleic acidmolecules, as reported further herein, phosphorothioate-modified nucleicacid molecules (including phosphorodithioate-modified) can increase theextent of immune stimulation of the nucleic acid molecule, whichcontains an unmethylated CpG dinucleotide as shown herein. InternationalPatent Application Publication Number: WO 95/26204 entitled “ImmuneStimulation By Phosphorothioate Oligonucleotide Analogs” also reports onthe non-sequence specific immunostimulatory effect of phosphorothioatemodified oligonucleotides. As reported herein, unmethylated CpGcontaining nucleic acid molecules having a phosphorothioate backbonehave been found to preferentially activate B-cell activity, whileunmethylated CpG containing nucleic acid molecules having aphosphodiester backbone have been found to preferentially activatemonocytic (macrophages, dendritic cells and monocytes) and NK cells.Phosphorothioate CpG oligonucleotides with preferred human motifs arealso strong activators of monocytic and NK cells.

Other stabilized nucleic acid molecules include: nonionic DNA analogs,such as alkyl- and aryl-phosphonates (in which the charged phosphonateoxygen is replaced by an alkyl or aryl group), phosphodiester andalkylphosphotriesters, in which the charged oxygen moiety is alkylated.Nucleic acid molecules which contain a diol, such as tetraethyleneglycolor hexaethyleneglycol, at either or both termini have also been shown tobe substantially resistant to nuclease degradation.

A “subject” shall mean a human or vertebrate animal including a dog,cat, horse, cow, pig, sheep, goat, chicken, monkey, rat, mouse, etc.

As used herein, the term “vector” refers to a nucleic acid moleculecapable of transporting another nucleic acid to which it has beenlinked. Preferred vectors are those capable of autonomous replicationand expression of nucleic acids to which they are linked (e.g., anepisome). Vectors capable of directing the expression of genes to whichthey are operatively linked are referred to herein as “expressionvectors.” In general, expression vectors of utility in recombinant DNAtechniques are often in the form of “plasmids” which refer generally tocircular double stranded DNA loops which, in their vector form, are notbound to the chromosome. In the present specification, “plasmid” and“vector” are used interchangeably as the plasmid is the most commonlyused form of vector. However, the invention is intended to include suchother forms of expression vectors which serve equivalent functions andwhich become known in the art subsequently hereto.

Certain Unmethylated CpG Containing Nucleic Acids Have B CellStimulatory Activity as Shown In Vitro and In Vivo

In the course of investigating the lymphocyte stimulatory effects of twoantisense oligonucleotides specific for endogenous retroviral sequences,using protocols described in the attached Examples 1 and 2, it wassurprisingly found that two out of twenty-four “controls” (includingvarious scrambled, sense, and mismatch controls for a panel of“antisense” ODN) also mediated B cell activation and IgM secretion,while the other “controls” had no effect.

Two observations suggested that the mechanism of this B cell activationby the “control” ODN may not involve antisense effects 1) comparison ofvertebrate DNA sequences listed in GenBank showed no greater homologythan that seen with non-stimulatory ODN and 2) the two controls showedno hybridization to Northern blots with 10 μg of spleen poly A+RNA.Resynthesis of these ODN on a different synthesizer or extensivepurification by polyacrylamide gel electrophoresis or high pressureliquid chromatography gave identical stimulation, eliminating thepossibility of an impurity. Similar stimulation was seen using B cellsfrom C3H/HeJ mice, eliminating the possibility that lipopolysaccharide(LPS) contamination could account for the results.

The fact that two “control” ODN caused B cell activation similar to thatof the two “antisense” ODN raised the possibility that all four ODN werestimulating B cells through some non-antisense mechanism involving asequence motif that was absent in all of the other nonstimulatorycontrol ODN. In comparing these sequences, it was discovered that all ofthe four stimulatory ODN contained CpG dinucleotides that were in adifferent sequence context from the nonstimulatory control.

To determine whether the CpG motif present in the stimulatory ODN wasresponsible for the observed stimulation, over 300 ODN ranging in lengthfrom 5 to 42 bases that contained methylated, unmethylated, or no CpGdinucleotides in various sequence contexts were synthesized. These ODNs,including the two original “controls” (ODN 1 and 2) and two originallysynthesized as “antisense” (ODN 3D and 3M; Krieg, A. M. J Immunol.143:2448 (1989)), were then examined for in vitro effects on spleencells (representative sequences are listed in Table 1). Several ODN thatcontained CpG dinucleotides induced B cell activation and IgM secretion;the magnitude of this stimulation typically could be increased by addingmore CpG dinucleotides (Table 1; compare ODN 2 to 2a or 3D to 3Da and3Db). Stimulation did not appear to result from an antisense mechanismor impurity. ODN caused no detectable proliferation of γδ or other Tcell populations.

Mitogenic ODN sequences uniformly became nonstimulatory if the CpGdinucleotide was mutated (Table 1; compare ODN 1 to 1a; 3D to 3Dc; 3M to3Ma; and 4 to 4a) or if the cytosine of the CpG dinucleotide wasreplaced by 5-methylcytosine (Table 1; ODN 1b, 2b, 3Dd, and 3Mb).Partial methylation of CpG motifs caused a partial loss of stimulatoryeffect (compare 2a to 2c, Table 1). In contrast, methylation of othercytosines did not reduce ODN activity (ODN 1c, 2d, 3De and 3Mc). Thesedata confirmed that a CpG motif is the essential element present in ODNthat activate B cells.

In the course of these studies, it became clear that the bases flankingthe CpG dinucleotide played an important role in determining the murineB cell activation induced by an ODN. The optimal stimulatory motif wasdetermined to consist of a CpG flanked by two 5′ purines (preferably aGpA dinucleotide) and two 3′ pyrimidines (preferably a TpT or TpCdinucleotide). Mutations of ODN to bring the CpG motif closer to thisideal improved stimulation (e.g. Table 1, compare ODN 2 to 2e; 3M to3Md) while mutations that disturbed the motif reduced stimulation (e.g.Table 1, compare ODN 3D to 3Df; 4 to 4b, 4c and 4d). On the other hand,mutations outside the CpG motif did not reduce stimulation (e.g. Table1, compare ODN 1 to 1d; 3D to 3Dg; 3M to 3Me). For activation of humancells, the best flanking bases are slightly different (See Table 5).

Of those tested, ODNs shorter than 8 bases were non-stimulatory (e.g.Table 1, ODN 4e). Among the forty-eight 8 base ODN tested, the moststimulatory sequence identified was TCAACGTT (ODN 4) which contains theself complementary “palindrome” AACGTT. In further optimizing thismotif, it was found that ODN containing Gs at both ends showed increasedstimulation, particularly if the ODN were rendered nuclease resistant byphosphorothioate modification of the terminal internucleotide linkages.ODN 1585 (5′GGGGTCAACGTTGAGGGGGG 3′ (SEQ ID NO:12)), in which the firsttwo and last five internucleotide linkages are phosphorothioate modifiedcaused an average 25.4 fold increase in mouse spleen cell proliferationcompared to an average 3.2 fold increase in proliferation induced by ODN1638, which has the same sequence as ODN 1585 except that the 10 Gs atthe two ends are replaced by 10 As. The effect of the G-rich ends iscis; addition of an ODN with poly G ends but no CpG motif to cells alongwith 1638 gave no increased proliferation. For nucleic acid moleculeslonger than 8 base pairs, non-palindromic motifs containing anunmethylated CpG were found to be more immunostimulatory.

Other octamer ODN containing a 6 base palindrome with a TpC dinucleotideat the 5′ end were also active (e.g. Table 1, ODN 4b,4c). Otherdinucleotides at the 5′ end gave reduced stimulation (e.g. ODN 4f; allsixteen possible dinucleotides were tested). The presence of a 3′dinucleotide was insufficient to compensate for the lack of a 5′dinucleotide (e.g. Table 1, ODN 4g). Disruption of the palindromeeliminated stimulation in octamer ODN (e.g. Table 1, ODN 4h), butpalindromes were not required in longer ODN.

TABLE 1 Oligonucleotide Stimulation of Mouse B Cells Stimulation Index′ODN Sequence ³H Production (5′ to 3′) Uridine IgM 1 (SEQ ID NO:13)GCTAGACGTTAGCGT 6.1 ± 0.8 17.9 ± 3.6  1a (SEQ ID NO:4) ......T........1.2 ± 0.2 1.7 ± 0.5 1b (SEQ ID NO:14) ......Z........ 1.2 ± 0.1 1.8± 0.0 1c (SEQ ID NO:15) ............Z.. 10.3 ± 4.4  9.5 ± 1.8 1d (SEQ IDNO:16) ..AT......GAGC. 13.0 ± 2.3  18.3 ± 7.5  2 (SEQ ID NO:17)ATGGAAGGTCCAGCGTTCTC 2.9 ± 0.2 13.6 ± 2.0  2a (SEQ ID NO:18)..C..CTC..G......... 7.7 ± 0.8 24.2 ± 3.2  2b (SEQ ID NO:19)..Z..CTC.ZG..Z...... 1.6 ± 0.5 2.8 ± 2.2 2c (SEQ ID NO:20)..Z..CTC..G......... 3.1 ± 0.6 7.3 ± 1.4 2d (SEQ ID NO:21)..C..CTC..G......Z.. 7.4 ± 1.4 27.7 ± 5.4  2e (SEQ ID NO:22)............A....... 5.6 ± 2.0 ND 3D (SEQ ID NO:23) GAGAACGCTGGACCTTCCAT4.9 ± 0.5 19.9 ± 3.6  3Da (SEQ ID NO:24) .........C.......... 6.6 ± 1.533.9 ± 6.8  3Db (SEQ ID NO:25) .........C.......G.. 10.1 ± 2.8  25.4± 0.8  3Dc (SEQ ID NO:26) ...C.A.............. 1.0 ± 0.1 1.2 ± 0.5 3Dd(SEQ ID NO:27) .....Z.............. 1.2 ± 0.2 1.0 ± 0.4 3De (SEQ IDNO:28) .............Z...... 4.4 ± 1.2 18.8 ± 4.4  3Df (SEQ ID NO:29).......A............ 1.6 ± 0.1 7.7 ± 0.4 3Dg (SEQ ID NO:30).........CC.G.ACTG.. 6.1 ± 1.5 18.6 ± 1.5  3M (SEQ ID NO:31)TCCATGTCGGTCCTGATGCT 4.1 ± 0.2 23.2 ± 4.9  3Ma (SEQ ID NO:32)......CT............ 0.9 ± 0.1 1.8 ± 0.5 3Mb (SEQ ID NO:33).......Z............ 1.3 ± 0.3 1.5 ± 0.6 3Mc (SEQ ID NO:34)...........Z........ 5.4 ± 1.5 8.5 ± 2.6 3Md (SEQ ID NO:35)......A..T.......... 17.2 ± 9.4  ND 3Me (SEQ ID NO:36)...............C..A. 3.6 ± 0.2 14.2 ± 5.2  4 TCAACGTT 6.1 ± 1.4 19.2± 5.2  4a ....GC.. 1.1 ± 0.2 1.5 ± 1.1 4b ...GCGC. 4.5 ± 0.2 9.6 ± 3.44c ...TCGA. 2.7 ± 1.0 ND 4d ..TT..AA 1.3 ± 0.2 ND 4e -....... 1.3 ± 0.21.1 ± 0.5 4f C....... 3.9 ± 1.4 ND 4g --......CT 1.4 ± 0.3 ND 4h.......C 1.2 ± 0.2 ND LPS 7.8 ± 2.5 4.8 ± 1.0 ′Stimulation indexes arethe means and std. dev. derived from at least 3 separate experiments,and are compared to wells cultured with no added ODN. ND = not done. CpGdinucleotides are underlined. Dots indicate identity; dashes indicatedeletions. Z indicates 5 methyl cytosine.

TABLE 2 Identification of the optimal CpG motif for Murine IL-6production and B cell activation. IL-6 (pg/ml)^(a) SEQUENCE SPLENIC IgMODN (5′–3′) CH12.LX B CELL SI^(b) (ng/ml)^(c)  512 (SEQ ID NO:37)TCCATGTCGGTCCTGATGCT 1300 ± 106  627 ± 43  5.8 ± 0.3  7315 ± 1324 1637(SEQ ID NO:38) ......C.............  136 ± 27   46 ± 6  1.7 ± 0.2   770± 72 1615 (SEQ ID NO:39) ......G............. 1201 ± 155  850 ± 202  3.7± 0.3  3212 ± 617 1614 (SEQ ID NO:40) ......A............. 1533 ± 3211812 ± 103 10.8 ± 0.6  7558 ± 414 1636 (SEQ ID NO:41).........A.......... 1181 ± 76  947 ± 132  5.4 ± 0.4  3983 ± 485 1634(SEQ ID NO:42) .........C.......... 1049 ± 223 1671 ± 175  9.2 ± 0.9 6256 ± 261 1619 (SEQ ID NO:43) .........T.......... 1555 ± 304 2908± 129 12.5 ± 1.0  8243 ± 698 1618 (SEQ ID NO:44) ......A..T..........2109 ± 291 2596 ± 166 12.9 ± 0.7 10425 ± 674 1639 (SEQ ID NO:45).....AA..T.......... 1827 ± 83 2012 ± 132 11.5 ± 0.4  9489 ± 103 1707(SEQ ID NO:46) ......A..TC......... ND 1147 ± 175  4.0 ± 0.2  3534 ± 2171708 (SEQ ID NO:47) .....CA..TG......... ND   59 ± 3  1.5 ± 0.1   466± 109 Dots indicate identity; CpG dinucleotides are underlined; ND = notdone ^(a)The experiment was done at least three times with similarresults. The level of IL-6 of unstimulated control cultures of bothCH12.LX and splenic B cells was ≦10 pg/ml. The IgM level of unstimulatedculture was 547 ± 82 ng/ml. CpG dinucleotides are underlined and dotsindicate identity. ^(b)[³H] Uridine uptake was indicated as a foldincrease (SI: stimulation index) from unstimulated control (2322.67± 213.68 cpm). Cells were stimulated with 20 μM of various CpG O-ODN.Data present the mean ± SD of triplicates ^(c)Measured by ELISA.

The kinetics of lymphocyte activation were investigated using mousespleen cells. When the cells were pulsed at the same time as ODNaddition and harvested just four hours later, there was already atwo-fold increase in ³H uridine incorporation. Stimulation peaked at12-48 hours and then decreased. After 24 hours, no intact ODN weredetected, perhaps accounting for the subsequent fall in stimulation whenpurified B cells with or without anti-IgM (at a submitogenic dose) werecultured with CpG ODN, proliferation was found to synergisticallyincrease about 10-fold by the two mitogens in combination after 48hours. The magnitude of stimulation was concentration dependent andconsistently exceeded that of LPS under optimal conditions for both.Oligonucleotides containing a nuclease resistant phosphorothioatebackbone were approximately two hundred times more potent thanunmodified oligonucleotides.

Cell cycle analysis was used to determine the proportion of B cellsactivated by CpG-ODN. CpG-ODN induced cycling in more than 95% of Bcells. Splenic B lymphocytes sorted by flow cytometry intoCD23−(marginal zone) and CD23+(follicular) subpopulations were equallyresponsive to ODN-induced stimulation, as were both resting andactivated populations of B cells isolated by fractionation over Percollgradients. These studies demonstrated that CpG-ODN induce essentiallyall B cells to enter the cell cycle.

Immunostimulatory Nucleic Acid Molecules Block Murine B Cell Apoptosis

Certain B cell lines such as WEHI-231 are induced to undergo growtharrest and/or apoptosis in response to crosslinking of their antigenreceptor by anti-IgM (Jakway, J. P. et al., “Growth regulation of the Blymphoma cell line WEHI-231 by anti-immunoglobulin, lipopolysaccharideand other bacterial products” J. Immunol. 137: 2225 (1986); Tsubata, T.,J. Wu and T. Honjo: B-cell apoptosis induced by antigen receptorcrosslinking is blocked by a T-cell signal through CD40.” Nature 364:645 (1993)). WEHI-231 cells are rescued from this growth arrest bycertain stimuli such as LPS and by the CD40 ligand. ODN containing theCpG motif were also found to protect WEHI-231 from anti-IgM inducedgrowth arrest, indicating that accessory cell populations are notrequired for the effect. Subsequent work indicates that CpG ODN induceBcl-x and myc expression, which may account for the protection fromapoptosis. Also, CpG nucleic acids have been found to block apoptosis inhuman cells. This inhibition of apoptosis is important, since it shouldenhance and prolong immune activation by CpG DNA.

Induction of Murine Cytokine Secretion by CpG Motifs in Bacterial DNA orOligonucleotides.

As described in Example 9, the amount of IL-6 secreted by spleen cellsafter CpG DNA stimulation was measured by ELISA. T cell depleted spleencell cultures rather than whole spleen cells were used for in vitrostudies following preliminary studies showing that T cells contributelittle or nothing to the IL-6 produced by CpG DNA-stimulated spleencells. As shown in Table 3, IL-6 production was markedly increased incells cultured with E. coli DNA but not in cells cultured with calfthymus DNA. To confirm that the increased IL-6 production observed withE. coli DNA was not due to contamination by other bacterial products,the DNA was digested with DNAse prior to analysis. DNAse pretreatmentabolished IL-6 production induced by E. coli DNA (Table 3). In addition,spleen cells from LPS-nonresponsive C3H/HeJ mouse produced similarlevels of IL-6 in response to bacterial DNA. To analyze whether the IL-6secretion induced by E. coli DNA was mediated by the unmethylated CpGdinucleotides in bacterial DNA, methylated E. coli DNA and a panel ofsynthetic ODN were examined. As shown in Table 3, CpG ODN significantlyinduced IL-6 secretion (ODN 5a, 5b, 5c) while CpG methylated E. coliDNA, or ODN containing methylated CpG (ODN 5f) or no CpG (ODN 5d) didnot. Changes at sites other than CpG dinucleotides (ODN 5b) ormethylation of other cytosines (ODN 5g) did not reduce the effect of CpGODN. Methylation of a single CpG in an ODN with three CpGs resulted in apartial reduction in the stimulation (compare ODN 5c to 5e; Table 3).

TABLE 3 Induction of Murine IL-6 secretion by CpG motifs in bacterialDNA or oligonucleotides. Treatment IL-6 (pg/ml) calf thymus DNA ≦10 calfthymus DNA + ≦10 DNase E. coli DNA 1169.5 ± 94.1  E. coli DNA + ≦10DNase CpG methylated E. ≦10 coli DNA LPS 280.1 ± 17.1 Media (no DNA) ≦10ODN 5a SEQ ID NO:1 ATGGACTCTCCAGCGTTCTC 1096.4 ± 372.0 5b SEQ ID NO:2.....AGG....A....... 1124.5 ± 126.2 5c SEQ ID NO:3 ..C.......G.........1783.0 ± 189.5 5d SEQ ID NO:4 .....AGG..C..T...... ≦10 5e SEQ ID NO:5..C.......G..Z......  851.1 ± 114.4 5f SEQ ID NO:6 ..Z......ZG..Z......≦10 5g SEQ ID NO:7 ..C.......G......Z.. 1862.3 ± 87.26 T cell depletedspleen cells from DBA/2 mice were stimulated with phosphodiestermodified oligonucleotides (O-ODN) (20 μM), calf thymus DNA (50 μg/ml) orE. coli DNA (50 μg/ml) with or without enzyme treatment, or LPS (10μg/ml) for 24 hr. Data represent the mean (pg/ml) ± SD of triplicates.CpG dinucleotides are underlined and dots indicate identity. Z indicates5-methylcytosine.

Identification of the Optimal CpG Motif for Induction of Murine IL-6 andIgM Secretion and B Cell Proliferation.

To evaluate whether the optimal B cell stimulatory CpG motif wasidentical with the optimal CpG motif for IL-6 secretion, a panel of ODNin which the bases flanking the CpG dinucleotide were progressivelysubstituted was studied. This ODN panel was analyzed for effects on Bcell proliferation, Ig production, and IL-6 secretion, using bothsplenic B cells and CH12.LX cells. As shown in Table 2, the optimalstimulatory motif is composed of an unmethylated CpG flanked by two 5′purines and two 3′ pyrimidines. Generally a mutation of either 5′ purineto pyrimidine or 3′ pyrimidine to purine significantly reduced itseffects. Changes in 5′ purines to C were especially deleterious, butchanges in 5′ purines to T or 3′ pyrimidines to purines had less markedeffects. Based on analyses of these and scores of other ODN, it wasdetermined that the optimal CpG motif for induction of IL-6 secretion isTGACGTT, which is identical with the optimal mitogenic and IgM-inducingCpG motif (Table 2). This motif was more stimulatory than any of thepalindrome containing sequences studied (1639, 1707 and 1708).

Titration of Induction of Murine IL-6 Secretion by CpG Motifs.

Bacterial DNA and CpG ODN induced IL-6 production in T cell depletedmurine spleen cells in a dose-dependent manner, but vertebrate DNA andnon-CpG ODN did not (FIG. 1). IL-6 production plateaued at approximately50 μg/ml of bacterial DNA or 40 μM of CpG O-ODN. The maximum levels ofIL-6 induced by bacterial DNA and CpG ODN were 1-1.5 ng/ml and 2-4 ng/mlrespectively. These levels were significantly greater than those seenafter stimulation by LPS (0.35 ng/ml) (FIG. 1A). To evaluate whether CpGODN with a nuclease-resistant DNA backbone would also induce IL-6production, S-ODN were added to T cell depleted murine spleen cells. CpGS-ODN also induced IL-6 production in a dose-dependent manner toapproximately the same level as CpG O-ODN while non-CpG S-ODN failed toinduce IL-6 (FIG. 1C). CpG S-ODN at a concentration of 0.05 μM couldinduce maximal IL-6 production in these cells. This result indicatedthat the nuclease-resistant DNA backbone modification retains thesequence specific ability of CpG DNA to induce IL-6 secretion and thatCpG S-ODN are more than 80-fold more potent than CpG O-ODN in this assaysystem.

Induction of Murine IL-6 Secretion by CpG DNA In Vivo.

To evaluate the ability of bacterial DNA and CpG S-ODN to induce IL-6secretion in vivo, BALB/c mice were injected iv. with 100 μg of E. coliDNA, calf thymus DNA, or CpG or non-stimulatory S-ODN and bled 2 hrafter stimulation. The level of IL-6 in the sera from the E. coli DNAinjected group was approximately 13 ng/ml while IL-6 was not detected inthe sera from calf thymus DNA or PBS injected groups (Table 4). CpGS-ODN also induced IL-6 secretion in vivo. The IL-6 level in the serafrom CpG S-ODN injected groups was approximately 20 ng/ml. In contrast,IL-6 was not detected in the sera from non-stimulatory S-ODN stimulatedgroup (Table 4).

TABLE 4 Secretion of Murine IL-6 induced by CpG DNA stimulation in vivo.Stimulant IL-6 (pg/ml) PBS <50 E. coli DNA 13858 ± 3143 Calf Thymus DNA<50 CpG S-ODN 20715 ± 606  non-CpG S-ODN <50 Mice (2 mice/group) werei.v. injected with 100 μl of PBS, 200 μg of E. coli DNA or calf thymusDNA, or 500 μg of CpG S-ODN or non-CpG control S-ODN. Mice were bled 2hr after injection and 1:10 dilution of each serum was analyzed by IL-6ELISA.Sensitivity limit of EL-6 ELISA was 5 pg/ml. Sequences of the CpGS-ODN is 5′GCATGACGTTGAGCT3′ (SEQ ID NO: 48) and of the non-stimulatoryS-ODN is 5′GCTAGATGTTAGCGT3′ (SEQ ID NO: 49). Note that although thereis a CpG in sequence 48, it is too close to the 3′ end to effectstimulation, as explained herein. Data represent mean ± SD ofduplicates. The experiment was done at least twice with similar results.

Kinetics of Murine IL-6 Secretion after Stimulation by CpG Motifs InVivo.

To evaluate the kinetics of induction of IL-6 secretion by CpG DNA invivo, BALB/c mice were injected iv. with CpG or control non-CpG S-ODN.Serum IL-6 levels were significantly increased within 1 hr and peaked at2 hr to a level of approximately 9 ng/ml in the CpG S-ODN injected group(FIG. 2). IL-6 protein in sera rapidly decreased after 4 hr and returnedto basal level by 12 hr after stimulation. In contrast to CpG DNAstimulated groups, no significant increase of IL-6 was observed in thesera from the non-stimulatory S-ODN or PBS injected groups (FIG. 2).

Tissue Distribution and Kinetics of IL-6 mRNA Expression Induced by CpGMotifs In Vivo.

As shown in FIG. 2, the level of serum IL-6 increased rapidly after CpGDNA stimulation. To investigate the possible tissue origin of this serumIL-6, and the kinetics of IL-6 gene expression in vivo after CpG DNAstimulation, BALB/c mice were injected iv with CpG or non-CpG S-ODN andRNA was extracted from liver, spleen, thymus, and bone marrow at varioustime points after stimulation. As shown in FIG. 3A, the level of IL-6mRNA in liver, spleen, and thymus was increased within 30 min. afterinjection of CpG S-ODN. The liver IL-6 mRNA peaked at 2 hrpost-injection and rapidly decreased and reached basal level 8 hr afterstimulation (FIG. 3A). Splenic IL-6 mRNA peaked at 2 hr afterstimulation and then gradually decreased (FIG. 3A). Thymus IL-6 mRNApeaked at 1 hr post-injection and then gradually decreased (FIG. 3A).IL-6 mRNA was significantly increased in bone marrow within 1 hr afterCpG S-ODN injection but then returned to basal level. In response to CpGS-ODN, liver, spleen and thymus showed more substantial increases inIL-6 mRNA expression than the bone marrow.

Patterns of Murine Cytokine Expression Induced by CpG DNA

In vivo or in whole spleen cells, no significant increase in the proteinlevels of the following interleukins: IL-2, IL-3, IL-4, IL-5, or IL-10was detected within the first six hours (Klinman, D. M. et al., (1996)Proc. Natl. Acad. Sci. USA 93:2879-2883). However, the level of TNF-α isincreased within 30 minutes and the level of IL-6 increased strikinglywithin 2 hours in the serum of mice injected with CpG ODN. Increasedexpression of IL-12 and interferon gamma (IFN-γ) mRNA by spleen cellswas also detected within the first two hours.

TABLE 5 Induction of human PBMC cytokine secrtetion by CpG oligos ODNSequence (5′–3′) IL-6¹ TNF-α¹ IFN-γ¹ GM-CSF IL-12  512TCCATGTCGGTCCTGATGCT 500 140 15.6 70 250 SEQ ID NO:37 1637......C............. 550 16 7.8 15.6 35 SEQ ID NO:38 1615......G............. 600 145 7.8 45 250 SEQ ID NO:39 1614......A............. 550 31 0 50 250 SEQ ID NO:40 1636.........A.......... 325 250 35 40 0 SEQ ID NO:41 1634.........C.......... 300 400 40 85 200 SEQ ID NO:42 1619.........T.......... 275 450 200 80 >500 SEQ ID NO:43 1618......A..T.......... 300 60 15.6 15.6 62 SEQ ID NO:44 1639.....AA..T.......... 625 220 15.6 40 60 SEQ ID NO:45 1707......A..TC......... 300 70 17 0 0 SEQ ID NO:46 1708.....CA..TG......... 270 10 17 0 0 SEQ ID NO:47 dots indicate identity;CpG dinucleotides are underlined ¹measured by ELISA using Quantikinekits from R&D Systems (pg/ml) Cells were cultured in 10% autologousserum with the indicated oligodeoxynucleotides (12 μg/ml) for 4 hr inthe case of TNF-α or 24 hr for the other cytokines before supernatantharvest and assay. Data are presented as the level of cytokine abovethat in wells with no added oligodeoxynucleotide.

CpG DNA Induces Cytokine Secretion by Human PBMC, Specifically Monocytes

The same panels of ODN used for studying mouse cytokine expression wereused to determine whether human cells also are induced by CpG motifs toexpress cytokine (or proliferate), and to identify the CpG motif(s)responsible. Oligonucleotide 1619 (GTCGTT) was the best inducer of TNF-αand IFN-γ secretion, and was closely followed by a nearly identicalmotif in oligonucleotide 1634 (GTCGCT) (Table 5). The motifs inoligodeoxynucleotides 1637 and 1614 (GCCGGT and GACGGT) led to strongIL-6 secretion with relatively little induction of other cytokines.Thus, it appears that human lymphocytes, like murine lymphocytes,secrete cytokines differentially in response to CpG dinucleotides,depending on the surrounding bases. Moreover, the motifs that stimulatemurine cells best differ from those that are most effective with humancells. Certain CpG oligodeoxynucleotides are poor at activating humancells (oligodeoxynucleotides 1707, 1708, which contain the palindromeforming sequences GACGTC and CACGTG respectively).

The cells responding to the DNA appear to be monocytes, since thecytokine secretion is abolished by treatment of the cells withL-leucyl-L-leucine methyl ester (L-LME), which is selectively toxic tomonocytes (but also to cytotoxic T lymphocytes and NK cells), and doesnot affect B cell Ig secretion (Table 6, and data not shown). The cellssurviving L-LME treatment had >95% viability by trypan blue exclusion,indicating that the lack of a cytokine response among these cells didnot simply reflect a nonspecific death all all cell types. Cytokinesecretion in response to E. coli (EC) DNA requires unmethylated CpGmotifs, since it is abolished by methylation of the EC DNA (next to thebottom row, Table 6). LPS contamination of the DNA cannot explain theresults since the level of contamination was identical in the native andmethylated DNA, and since addition of twice the highest amount ofcontaminating LPS had no effect (not shown).

TABLE 6 CpG DNA induces cytokine secretion by human PBMC TNF-α IL-6EFN-γ RANTES DNA (pg/ml)¹ (pg/ml) (pg/ml) (pg/ml) EC DNA (50 μg/ml) 90012,000 700 1560 EC DNA (5 μg/ml) 850 11,000 400 750 EC DNA (0.5 μg/ml)500 ND 200 0 EC DNA (0.05 μg/ml) 62.5 10,000 15.6 0 EC DNA (50 μg/ml) +0 ND ND ND L-LME² EC DNA (10 μg/ml) 0 5 ND ND Methyl.³ CT DNA (50 μg/ml)0 600 0 0 ¹Levels of all cytokines were determined by ELISA usingQuantikine kits from R&D Systems as described in the previous table.Results are representative using PBMC from different donors. ²Cells werepretreated for 15 min. with L-leucyl-L-leucine methyl ester (M-LME) todetermine whether the cytokine production under these conditions wasfrom monocytes (or other L-LME-sensitive cells). ³EC DNA was methylatedusing 2U/μg DNA of CpG methylase (New England Biolabs) according to themanufacturer's directions, and methylation confirmed by digestion withHpa-II and Msp-I. As a negative control, samples were includedcontaining twice the maximal amount of LPS contained in the highestconcentration of EC DNA which failed to induce detectable cytokineproduction under these experimental conditions. ND = not done

The loss of cytokine production in the PBMC treated with L-LME suggestedthat monocytes may be responsible for cytokine production in response toCpG DNA. To test this hypothesis more directly, the effects of CpG DNAon highly purified human monocytes and macrophages was tested. Ashypothesized, CpG DNA directly activated production of the cytokinesIL-6, GM-CSF, and TNF-α by human macrophages, whereas non-CpG DNA didnot (Table 7).

TABLE 7 CpG DNA induces cytokine expression in purified humanmacrophages IL-6 GM-CSF TNF-α (pg/ml) (pg/ml) (pg/ml) Cells alone 0 0 0CT DNA (50 μg/ml) 0 0 0 EC DNA (50 μg/ml) 2000 15.6 1000

Biological Role of IL-6 in Inducing Murine IgM Production in Response toCpG Motifs.

The kinetic studies described above revealed that induction of IL-6secretion, which occurs within 1 hr post CpG stimulation, precedes IgMsecretion. Since the optimal CpG motif for ODN inducing secretion ofIL-6 is the same as that for IgM (Table 2), whether the CpG motifsindependently induce IgM and IL-6 production or whether the IgMproduction is dependent on prior IL-6 secretion was examined. Theaddition of neutralizing anti-IL-6 antibodies inhibited in vitro IgMproduction mediated by CpG ODN in a dose-dependent manner but a controlantibody did not (FIG. 4A). In contrast, anti-IL-6 addition did notaffect either the basal level or the CpG-induced B cell proliferation(FIG. 4B).

Increased Transcriptional Activity of the IL-6 Promoter in Response toCpG DNA.

The increased level of IL-6 mRNA and protein after CpG DNA stimulationcould result from transcriptional or post-transcriptional regulation. Todetermine if the transcriptional activity of the IL-6 promoter wasupregulated in B cells cultured with CpG ODN, a murine B cell line,WEHI-231, which produces IL-6 in response to CpG DNA, was transfectedwith an IL-6 promoter-CAT construct (pIL-6/CAT) (Pottratz, S. T. et al.,17B-estradiol) inhibits expression of humaninterleukin-6-promoter-reporter constructs by a receptor-dependentmechanism. J. Clin. Invest. 93:944). CAT assays were performed afterstimulation with various concentrations of CpG or non-CpG ODN. As shownin FIG. 5, CpG ODN induced increased CAT activity in dose-dependentmanner while non-CpG ODN failed to induce CAT activity. This confirmsthat CpG induces the transcriptional activity of the IL-6 promoter.

Dependence of B Cell Activation by CpG ODN on the Number of 5′ and 3′Phosphorothioate Internucleotide Linkages.

To determine whether partial sulfur modification of the ODN backbonewould be sufficient to enhance B cell activation, the effects of aseries of ODN with the same sequence, but with differing numbers of Sinternucleotide linkages at the 5′ and 3′ ends were tested. Based onprevious studies of nuclease degradation of ODN, it was determined thatat least two phosphorothioate linkages at the 5′ end of ODN wererequired to provide optimal protection of the ODN from degradation byintracellular exo- and endo-nucleases. Only chimeric ODN containing two5′ phosphorothioate-modified linkages, and a variable number of 3′modified linkages were therefore examined.

The lymphocyte stimulating effects of these ODN were tested at threeconcentrations (3.3, 10, and 30 μM) by measuring the total levels of RNAsynthesis (by ³H uridine incorporation) or DNA synthesis (by ³Hthymidine incorporation) in treated spleen cell cultures (Example 10).O-ODN (0/0 phosphorothioate modifications) bearing a CpG motif caused nospleen cell stimulation unless added to the cultures at concentrationsof at least 10 μM (Example 10). However, when this sequence was modifiedwith two S linkages at the 5′ end and at least three S linkages at the3′ end, significant stimulation was seen at a dose of 3.3 μM. At thislow dose, the level of stimulation showed a progressive increase as thenumber of 3′ modified bases was increased, until this reached orexceeded six, at which point the stimulation index began to decline. Ingeneral, the optimal number of 3′ S linkages for spleen cell stimulationwas five. At all three concentrations tested in these experiments, theS-ODN was less stimulatory than the optimal chimeric compounds.

Dependence of CpG-Mediated Lymphocyte Activation on the Type of BackboneModification.

Phosphorothioate modified ODN (S-ODN) are far more nuclease resistantthan phosphodiester modified ODN (O-ODN). Thus, the increased immunestimulation caused by S-ODN and S-O-ODN (i.e. chimeric phosphorothioateODN in which the central linkages are phosphodiester, but the two 5′ andfive 3′ linkages are phosphorothioate modified) compared to O-ODN mayresult from the nuclease resistance of the former. To determine the roleof ODN nuclease resistance in immune stimulation by CpG ODN, thestimulatory effects of chimeric ODN in which the 5′ and 3′ ends wererendered nuclease resistant with either methylphosphonate (MP-),methylphosphorothioate (MPS-), phosphorothioate (S-), orphosphorodithioate (S₂-) internucleotide linkages were tested (Example10). These studies showed that despite their nuclease resistance,MP-O-ODN were actually less immune stimulatory than O-ODN. However,combining the MP and S modifications by replacing both nonbridging Omolecules with 5′ and 3′ MPS internucleotide linkages restored immunestimulation to a slightly higher level than that triggered by O-ODN.

S-O-ODN were far more stimulatory than O-ODN, and were even morestimulatory than S-ODN, at least at concentrations above 3.3 μM. Atconcentrations below 3 μM, the S-ODN with the 3M sequence was morepotent than the corresponding S-O-ODN, while the S-ODN with the 3Dsequence was less potent than the corresponding S-O-ODN (Example 10). Incomparing the stimulatory CpG motifs of these two sequences, it wasnoted that the 3D sequence is a perfect match for the stimulatory motifin that the CpG is flanked by two 5′ purines and two 3′ pyrimidines.However, the bases immediately flanking the CpG in ODN 3D are notoptimal; it has a 5′ pyrimidine and a 3′ purine. Based on furthertesting, it was found that the sequence requirement for immunestimulation is more stringent for S-ODN than for S-O- or O-ODN. S-ODNwith poor matches to the optimal CpG motif cause little or no lymphocyteactivation (e.g. Sequence 3D). However, S-ODN with good matches to themotif, most critically at the positions immediately flanking the CpG,are more potent than the corresponding S-O-ODN (e.g. Sequence 3M,Sequences 4 and 6), even though at higher concentrations (greater than 3μM) the peak effect from the S-O-ODN is greater (Example 10).

S₂-O-ODN were remarkably stimulatory, and caused substantially greaterlymphocyte activation than the corresponding S-ODN or S-O-ODN at everytested concentration.

The increased B cell stimulation seen with CpG ODN bearing S or S₂substitutions could result from any or all of the following effects:nuclease resistance, increased cellular uptake, increased proteinbinding, and altered intracellular localization. However, nucleaseresistance can not be the only explanation, since the MP-O-ODN wereactually less stimulatory than the O-ODN with CpG motifs. Prior studieshave shown that ODN uptake by lymphocytes is markedly affected by thebackbone chemistry (Zhao et al., (1993) Comparison of cellular bindingand uptake of antisense phosphodiester, phosphorothioate, and mixedphosphorothioate and methylphosphonate oligonucleotides. (AntisenseResearch and Development 3, 53-66; Zhao et al., (1994) Stage specificoligonucleotide uptake in murine bone marrow B cell precursors. Blood84, 3660-3666.) The highest cell membrane binding and uptake was seenwith S-ODN, followed by S-O-ODN, O-ODN, and MP-ODN. This differentialuptake correlates well with the degree of immune stimulation.

Unmethylated CpG Containing Oligos have NK Cell Stimulatory Activity

Experiments were conducted to determine whether CpG containingoligonucleotides stimulated the activity of natural killer (NK) cells inaddition to B cells. As shown in Table 8, a marked induction of NKactivity among spleen cells cultured with CpG ODN 1 and 3Dd wasobserved. In contrast, there was relatively no induction in effectorsthat had been treated with non-CpG control ODN.

TABLE 8 Induction Of NK Activity By CpG Oligodeoxynucleotides (ODN) %YAC-1 Specific Lysis* % 2C11 Specific Lysis Effector: Target Effector:Target ODN 50:1 100:1 50:1 100:1 None −1.1 −1.4 15.3 16.6 1 16.1 24.538.7 47.2 3Dd 17.1 27.0 37.0 40.0 non-CpG ODN −1.6 −1.7 14.8 15.4

Induction of NK Activity by DNA Containing CpG Motifs, but not byNon-CpG DNA.

Bacterial DNA cultured for 18 hrs. at 37° C. and then assayed forkilling of K562 (human) or Yac-1 (mouse) target cells induced NK lyticactivity in both mouse spleen cells depleted of B cells and human PBMC,but vertebrate DNA did not (Table 9). To determine whether thestimulatory activity of bacterial DNA may be a consequence of itsincreased level of unmethylated CpG dinucleotides, the activatingproperties of more than 50 synthetic ODN containing unmethylated,methylated, or no CpG dinucleotides was tested. The results, summarizedin Table 9, demonstrate that synthetic ODN can stimulate significant NKactivity, as long as they contain at least one unmethylated CpGdinucleotide. No difference was observed in the stimulatory effects ofODN in which the CpG was within a palindrome (such as ODN 1585, whichcontains the palindrome AACGTT) from those ODN without palindromes (suchas 1613 or 1619), with the caveat that optimal stimulation was generallyseen with ODN in which the CpG was flanked by two 5′ purines or a 5′ GpTdinucleotide and two 3′ pyrimidines. Kinetic experiments demonstratedthat NK activity peaked around 18 hrs. after addition of the ODN. Thedata indicates that the murine NK response is dependent on the prioractivation of monocytes by CpG DNA, leading to the production of IL-12,TNF-α, and IFN-α/β (Example 11).

TABLE 9 Induction of NK Activity by DNA Containing CpG Motifs but not byNon-CpG DNA LU/10⁶ Mouse Human DNA or Cytokine Added Cells Cells Expt. 1None 0.00 0.00 IL-2 16.68 15.82 E. coli DNA 7.23 5.05 Calf thymus DNA0.00 0.00 Expt. 2 None 0.00 3.28 1585 gggGTCAACGTTGAgggggG (SEQ IDNO:12) 7.38 17.98 1629 .......gtc.......... (SEQ ID NO:50) 0.00 4.4Expt. 3 None 0.00 1613 GCTAGACGTTAGTGT (SEQ ID NO:51) 5.22 1769.......Z....... (SEQ ID NO:52) 0.02 ND 1619 TCCATGTCGTTCCTGATGCT (SEQ IDNO:43) 3.35 1765 .......Z............ (SEQ ID NO:53) 0.11 CpGdinucleotides in ODN sequences are indicated by underlying; Z indicatesmethylcytosine. Lower case letters indicate nuclease resistantphosphorothioate modified internucleotide linkages which, in titrationexperiments, were more than 20 times as potent as non-modified ODN,depending on the flanking bases. Poly G ends (g) were used in some ODN,because they significantly increase the level of ODN uptake.

From all of these studies, a more complete understanding of the immuneeffects of CpG DNA has been developed, which is summarized in FIG. 6.

Identification of B Cell and Monocyte/NK Cell-Specific Oligonucleotides

As shown in FIG. 6, CpG DNA can directly activate highly purified Bcells and monocytic cells. There are many similarities in the mechanismthrough which CpG DNA activates these cell types. For example, bothrequire NFκB activation as explained further below.

In further studies of different immune effects of CpG DNA, it was foundthat there is more than one type of CpG motif. Specifically, oligo 1668,with the best mouse B cell motif, is a strong inducer of both B cell andnatural killer (NK) cell activation, while oligo 1758 is a weak B cellactivator, but still induces excellent NK responses (Table 10).

TABLE 10 Different CpG motifs stimulate optimal murine B cell and NKactivation B cell NK ODN Sequence activation¹ activation² 1668TCCATGACGTTCCTGATGCT 42,849 2.52 (SEQ ID NO:54) 1758 TCTCCCAGCGTGCGCCAT1,747 6.66 (SEQ ID NO:55) NONE 367 0.00 CpG dinucleotides areunderlined; oligonucleotides were synthesized with phosphorothioatemodified backbones to improve their nuclease resistance. ¹Measured by ³Hthymidine incorporation after 48 hr culture with oligodeoxynucleotidesat a 200 nM concentration as described in Example 1. ²Measured in lyticunits.

Teleological Basis of Immunostimulatory, Nucleic Acids

Vertebrate DNA is highly methylated and CpG dinucleotides areunderrepresented. However, the stimulatory CpG motif is common inmicrobial genomic DNA, but quite rare in vertebrate DNA. In addition,bacterial DNA has been reported to induce B cell proliferation andimmunoglobulin (Ig) production, while mammalian DNA does not (Messina,J. P. et al., J. Immunol. 147:1759 (1991)). Experiments furtherdescribed in Example 3, in which methylation of bacterial DNA with CpGmethylase was found to abolish mitogenicity, demonstrates that thedifference in CpG status is the cause of B cell stimulation by bacterialDNA. This data supports the following conclusion: that unmethylated CpGdinucleotides present within bacterial DNA are responsible for thestimulatory effects of bacterial DNA.

Teleologically, it appears likely that lymphocyte activation by the CpGmotif represents an immune defense mechanism that can therebydistinguish bacterial from host DNA. Host DNA, which would commonly bepresent in many anatomic regions and areas of inflammation due toapoptosis (cell death), would generally induce little or no lymphocyteactivation due to CpG suppression and methylation. However, the presenceof bacterial DNA containing unmethylated CpG motifs can cause lymphocyteactivation precisely in infected anatomic regions, where it isbeneficial. This novel activation pathway provides a rapid alternativeto T cell dependent antigen specific B cell activation. Since the CpGpathway synergizes with B cell activation through the antigen receptor,B cells bearing antigen receptor specific for bacterial antigens wouldreceive one activation signal through cell membrane Ig and a secondsignal from bacterial DNA, and would therefore tend to be preferentiallyactivated. The interrelationship of this pathway with other pathways ofB cell activation provide a physiologic mechanism employing a polyclonalantigen to induce antigen-specific responses.

However, it is likely that B cell activation would not be totallynonspecific. B cells bearing antigen receptors specific for bacterialproducts could receive one activation signal through cell membrane Ig,and a second from bacterial DNA, thereby more vigorously triggeringantigen specific immune responses. As with other immune defensemechanisms, the response to bacterial DNA could have undesirableconsequences in some settings. For example, autoimmune responses to selfantigens would also tend to be preferentially triggered by bacterialinfections, since autoantigens could also provide a second activationsignal to autoreactive B cells triggered by bacterial DNA. Indeed theinduction of autoimmunity by bacterial infections is a common clinicalobservance. For example, the autoimmune disease systemic lupuserythematosus, which is: i) characterized by the production of anti-DNAantibodies; ii) induced by drugs which inhibit DNA methyltransferase(Cornacchia, E. J. et al., J. Clin. Invest. 92:38 (1993)); and iii)associated with reduced DNA methylation (Richardson, B. L. et al., Arth.Rheum 35:647 (1992)), is likely triggered at least in part by activationof DNA-specific B cells through stimulatory signals provided by CpGmotifs, as well as by binding of bacterial DNA to antigen receptors.

Further, sepsis, which is characterized by high morbidity and mortalitydue to massive and nonspecific activation of the immune system may beinitiated by bacterial DNA and other products released from dyingbacteria that reach concentrations sufficient to directly activate manylymphocytes. Further evidence of the role of CpG DNA in the sepsissyndrome is described in Cowdery, J., et. al., (1996) The Journal ofImmunology 156:4570-4575.

Proposed Mechanisms of Action

Unlike antigens that trigger B cells through their surface Ig receptor,CpG-ODN did not induce any detectable Ca²⁺ flux, changes in proteintyrosine phosphorylation, or IP 3 generation. Flow cytometry withFITC-conjugated ODN with or without a CpG motif was performed asdescribed in Zhao, Q et al., (Antisense Research and Development 3:53-66(1993)), and showed equivalent membrane binding, cellular uptake,efflux, and intracellular localization. This suggests that there may notbe cell membrane proteins specific for CpG ODN. Rather than actingthrough the cell membrane, that data suggests that unmethylated CpGcontaining oligonucleotides require cell uptake for activity: ODNcovalently linked to a solid Teflon support were nonstimulatory, as werebiotinylated ODN immobilized on either avidin beads or avidin coatedpetri dishes. CpG ODN conjugated to either FITC or biotin retained fullmitogenic properties, indicating no steric hindrance.

Recent data indicate the involvement of the transcription factor NFκB asa direct or indirect mediator of the CpG effect. For example, within 15minutes of treating B cells or monocytes with CpG DNA, the level of NFkBbinding activity is increased (FIG. 7). However, it is not increased byDNA that does not contain CpG motifs. In addition, it was found that twodifferent inhibitors of NFκB activation, PDTC and gliotoxin, completelyblock the lymphocyte stimulation by CpG DNA as measured by B cellproliferation or monocytic cell cytokine secretion, suggesting that NFκBactivation is required for both cell types.

There are several possible mechanisms through which NFκB can beactivated. These include through activation of various protein kinases,or through the generation of reactive oxygen species. No evidence forprotein kinase activation induced immediately after CpG DNA treatment ofB cells or monocytic cells have been found, and inhibitors of proteinkinase A, protein kinase C, and protein tyrosine kinases had no effectson the CpG induced activation. However, CpG DNA causes a rapid inductionof the production of reactive oxygen species in both B cells andmonocytic cells, as detected by the sensitive fluorescent dyedihydrorhodamine 123 as described in Royall, J. A., and Ischiropoulos,H. (Archives of Biochemistry and Biophysics 302:348-355 (1993)).Moreover, inhibitors of the generation of these reactive oxygen speciescompletely block the induction of NFκB and the later induction of cellproliferation and cytokine secretion by CpG DNA.

Working backwards, the next question was how CpG DNA leads to thegeneration of reactive oxygen species so quickly. Previous studies bythe inventors demonstrated that oligonucleotides and plasmid orbacterial DNA are taken up by cells into endosomes. These endosomesrapidly become acidified inside the cell. To determine whether thisacidification step may be important in the mechanism through which CpGDNA activates reactive oxygen species, the acidification step wasblocked with specific inhibitors of endosome acidification includingchloroquine, monensin, and bafilomycin, which work through differentmechanisms. FIG. 8A shows the results from a flow cytometry study usingmouse B cells with the dihydrorhodamine 123 dye to determine levels ofreactive oxygen species. The dye only sample in Panel A of the figureshows the background level of cells positive for the dye at 28.6%. Asexpected, this level of reactive oxygen species was greatly increased to80% in the cells treated for 20 minutes with PMA and ionomycin, apositive control (Panel B). The cells treated with the CpG oligo alsoshowed an increase in the level of reactive oxygen species such thatmore than 50% of the cells became positive (Panel D). However, cellstreated with an oligonucleotide with the identical sequence except thatthe CpG was switched did not show this significant increase in the levelof reactive oxygen species (Panel E).

In the presence of chloroquine, the results are very different (FIG.8B). Chloroquine slightly lowers the background level of reactive oxygenspecies in the cells such that the untreated cells in Panel A have only4.3% that are positive. Chloroquine completely abolishes the inductionof reactive oxygen species in the cells treated with CpG DNA (Panel B)but does not reduce the level of reactive oxygen species in the cellstreated with PMA and ionomycin (Panel E). This demonstrates that unlikethe PMA plus ionomycin, the generation of reactive oxygen speciesfollowing treatment of B cells with CpG DNA requires that the DNAundergo an acidification step in the endosomes. This is a completelynovel mechanism of leukocyte activation. Chloroquine, monensin, andbafilomycin also appear to block the activation of NFκB by CpG DNA aswell as the subsequent proliferation and induction of cytokinesecretion.

Presumably, there is a protein in or near the endosomes thatspecifically recognizes DNA containing CpG motifs and leads to thegeneration of reactive oxygen species. To detect any protein in the cellcytoplasm that may specifically bind CpG DNA, we used electrophoreticmobility shift assays (EMSA) with 5′ radioactively labeledoligonucleotides with or without CpG motifs. A band was found thatappears to represent a protein binding specifically to single strandedoligonucleotides that have CpG motifs, but not to oligonucleotides thatlack CpG motifs or to oligonucleotides in which the CpG motif has beenmethylated. This binding activity is blocked if excess ofoligonucleotides that contain the NFκB binding site was added. Thissuggests that an NFκB or related protein is a component of a protein orprotein complex that binds the stimulatory CpG oligonucleotides.

No activation of CREB/ATF proteins was found at time points where NFκBwas strongly activated. These data therefore do not provide proof thatNFκB proteins actually bind to the CpG nucleic acids, but rather thatthe proteins are required in some way for the CpG activity. It ispossible that a CREB/ATF or related protein may interact in some waywith NFkB proteins or other proteins thus explaining the remarkablesimilarity in the binding motifs for CREB proteins and the optimal CpGmotif. It remains possible that the oligos bind to a CREB/ATF or relatedprotein, and that this leads to NFκB activation.

Alternatively, it is very possible that the CpG nucleic acids may bindto one of the TRAF proteins that bind to the cytoplasmic region of CD40and mediate NFκB activation when CD40 is cross-linked. Examples of suchTRAF proteins include TRAF-2 and TRAF-5.

Method for Making Immunostimulatory Nucleic Acids

For use in the instant invention, nucleic acids can be synthesized denovo using any of a number of procedures well known in the art. Forexample, the β-cyanoethyl phosphoramidite method (S. L. Beaucage and M.H. Caruthers, (1981) Tet. Let. 22:1859); nucleoside H-phosphonate method(Garegg et al., (1986) Tet. Let. 27: 4051-4054; Froehler et al., (1986)Nucl. Acid. Res. 14: 5399-5407; Garegg et al., (1986) Tet. Let. 27:4055-4058, Gaffney et al., (1988) Tet. Let. 29:2619-2622). Thesechemistries can be performed by a variety of automated oligonucleotidesynthesizers available in the market. Alternatively, oligonucleotidescan be prepared from existing nucleic acid sequences (e.g. genomic orcDNA) using known techniques, such as those employing restrictionenzymes, exonucleases or endonucleases.

For use in vivo, nucleic acids are preferably relatively resistant todegradation (e.g. via endo- and exo-nucleases). Secondary structures,such as stem loops, can stabilize nucleic acids against degradation.Alternatively, nucleic acid stabilization can be accomplished viaphosphate backbone modifications. A preferred stabilized nucleic acidhas at least a partial phosphorothioate modified backbone.Phosphorothioates may be synthesized using automated techniquesemploying either phosphoramidate or H-phosphonate chemistries. Aryl- andalkyl-phosphonates can be made e.g. as described in U.S. Pat. No.4,469,863; and alkylphosphotriesters (in which the charged oxygen moietyis alkylated as described in U.S. Pat. No. 5,023,243 and European PatentNo. 092,574) can be prepared by automated solid phase synthesis usingcommercially available reagents. Methods for making other DNA backbonemodifications and substitutions have been described (Uhlmann, E. andPeyman, A. (1990) Chem. Rev. 90:544; Goodchild, J. (1990) BioconjugateChem. 1:165). 2′-O-methyl nucleic acids with CpG motifs also causeimmune activation, as do ethoxy-modified CpG nucleic acids. In fact, nobackbone modifications have been found that completely abolish the CpGeffect, although it is greatly reduced by replacing the C with a5-methyl C.

For administration in vivo, nucleic acids may be associated with amolecule that results in higher affinity binding to target cell (e.g.B-cell, monocytic cell and natural killer (NK) cell) surfaces and/orincreased cellular uptake by target cells to form a “nucleic aciddelivery complex”. Nucleic acids can be ionically, or covalentlyassociated with appropriate molecules using techniques which are wellknown in the art. A variety of coupling or crosslinking agents can beused e.g. protein A, carbodiimide, andN-succinimidyl-3-(2-pyridyldithio) propionate (SPDP). Nucleic acids canalternatively be encapsulated in liposomes or virosomes using well-knowntechniques.

Therapeutic Uses of Immunostimulatory Nucleic Acid Molecules

Based on their immunostimulatory properties, nucleic acid moleculescontaining at least one unmethylated CpG dinucleotide can beadministered to a subject in vivo to treat an “immune systemdeficiency”. Alternatively, nucleic acid molecules containing at leastone unmethylated CpG dinucleotide can be contacted with lymphocytes(e.g. B cells, monocytic cells or NK cells) obtained from a subjecthaving an immune system deficiency ex vivo and activated lymphocytes canthen be reimplanted in the subject.

As reported herein, in response to unmethylated CpG containing nucleicacid molecules, an increased number of spleen cells secrete IL-6, IL-12,IFN-γ, IFN-α, IFN-β, IL-1, IL-3, IL-10, TNF-α, TNF-β, GM-CSF, RANTES,and probably others. The increased IL-6 expression was found to occur inB cells, CD4⁺ T cells and monocytic cells.

Immunostimulatory nucleic acid molecules can also be administered to asubject in conjunction with a vaccine to boost a subject's immune systemand thereby effect a better response from the vaccine. Preferably theimmunostimulatory nucleic acid molecule is administered slightly beforeor at the same time as the vaccine. A conventional adjuvant mayoptionally be administered in conjunction with the vaccine, which isminimally comprised of an antigen, as the conventional adjuvant mayfurther improve the vaccination by enhancing antigen absorption.

When the vaccine is a DNA vaccine at least two components determine itsefficacy. First, the antigen encoded by the vaccine determines thespecificity of the immune response. Second, if the backbone of theplasmid contains CpG motifs, it functions as an adjuvant for thevaccine. Thus, CpG DNA acts as an effective “danger signal” and causesthe immune system to respond vigorously to new antigens in the area.This mode of action presumably results primarily from the stimulatorylocal effects of CpG DNA on dendritic cells and other “professional”antigen presenting cells, as well as from the costimulatory effects on Bcells.

Immunostimulatory oligonucleotides and unmethylated CpG containingvaccines, which directly activate lymphocytes and co-stimulate anantigen-specific response, are fundamentally different from conventionaladjuvants (e.g. aluminum precipitates), which are inert when injectedalone and are thought to work through absorbing the antigen and therebypresenting it more effectively to immune cells. Further, conventionaladjuvants only work for certain antigens, only induce an antibody(humoral) immune response (Th2), and are very poor at inducing cellularimmune responses (Th1). For many pathogens, the humoral responsecontributes little to protection, and can even be detrimental.

In addition, an immunostimulatory oligonucleotide can be administeredprior to, along with or after administration of a chemotherapy orimmunotherapy to increase the responsiveness of the malignant cells tosubsequent chemotherapy or immunotherapy or to speed the recovery of thebone marrow through induction of restorative cytokines such as GM-CSF.CpG nucleic acids also increase natural killer cell lytic activity andantibody dependent cellular cytotoxicity (ADCC). Induction of NKactivity and ADCC may likewise be beneficial in cancer immunotherapy,alone or in conjunction with other treatments.

Another use of the described immunostimulatory nucleic acid molecules isin desensitization therapy for allergies, which are generally caused byIgE antibody generation against harmless allergens. The cytokines thatare induced by unmethylated CpG nucleic acids are predominantly of aclass called “Th1” which is most marked by a cellular immune responseand is associated with IL-12 and IFN-γ. The other major type of immuneresponse is termed a Th2 immune response, which is associated with moreof an antibody immune response and with the production of IL-4, IL-5 andIL-10. In general, it appears that allergic diseases are mediated by Th2type immune responses and autoimmune diseases by Th1 immune response.Based on the ability of the immunostimulatory nucleic acid molecules toshift the immune response in a subject from a Th2 (which is associatedwith production of IgE antibodies and allergy) to a Th1 response (whichis protective against allergic reactions), an effective dose of animmunostimulatory nucleic acid (or a vector containing a nucleic acid)alone or in conjunction with an allergen can be administered to asubject to treat or prevent an allergy.

Nucleic acids containing unmethylated CpG motifs may also havesignificant therapeutic utility in the treatment of asthma. Th2cytokines, especially IL-4 and IL-5 are elevated in the airways ofasthmatic subjects. These cytokines promote important aspects of theasthmatic inflammatory response, including IgE isotype switching,eosinophil chemotaxis and activation and mast cell growth. Th1cytokines, especially IFN-γ and IL-12, can suppress the formation of Th2clones and production of Th2 cytokines.

As described in detail in the following Example 12, oligonucleotidescontaining an unmethylated CpG motif (i.e. TCCATGACGTTCCTGACGTT; SEQ IDNO: 10), but not a control oligonucleotide (TCCATGAGCTTCCTGAGTCT; SEQ IDNO:11) prevented the development of an inflammatory cellular infiltrateand eosinophilia in a murine model of asthma. Furthermore, thesuppression of eosinophilic inflammation was associated with asuppression of a Th2 response and induction of a Th1 response.

For use in therapy, an effective amount of an appropriateimmunostimulatory nucleic acid molecule alone or formulated as adelivery complex can be administered to a subject by any mode allowingthe oligonucleotide to be taken up by the appropriate target cells(e.g., B-cells and monocytic cells). Preferred routes of administrationinclude oral and transdermal (e.g., via a patch). Examples of otherroutes of administration include injection (subcutaneous, intravenous,parenteral, intraperitoneal, intrathecal, etc.). The injection can be ina bolus or a continuous infusion.

A nucleic acid alone or as a nucleic acid delivery complex can beadministered in conjunction with a pharmaceutically acceptable carrier.As used herein, the phrase “pharmaceutically acceptable carrier” isintended to include substances that can be coadministered with a nucleicacid or a nucleic acid delivery complex and allows the nucleic acid toperform its indicated function. Examples of such carriers includesolutions, solvents, dispersion media, delay agents, emulsions and thelike. The use of such media for pharmaceutically active substances arewell known in the art. Any other conventional carrier suitable for usewith the nucleic acids falls within the scope of the instant invention.

The language “effective amount” of a nucleic acid molecule refers to theamount necessary or sufficient to realize a desired biologic effect. Forexample, an effective amount of a nucleic acid containing at least oneunmethylated CpG for treating an immune system deficiency could be thatamount necessary to eliminate a tumor, cancer, or bacterial, viral orfungal infection. An effective amount for use as a vaccine adjuvantcould be that amount useful for boosting a subjects immune response to avaccine. An “effective amount” for treating asthma can be that amountuseful for redirecting a Th2 type of immune response that is associatedwith asthma to a Th1 type of response. The effective amount for anyparticular application can vary depending on such factors as the diseaseor condition being treated, the particular nucleic acid beingadministered (e.g. the number of unmethylated CpG motifs or theirlocation in the nucleic acid), the size of the subject, or the severityof the disease or condition. One of ordinary skill in the art canempirically determine the effective amount of a particularoligonucleotide without necessitating undue experimentation.

The present invention is further illustrated by the following Exampleswhich in no way should be construed as further limiting. The entirecontents of all of the references (including literature references,issued patents, published patent applications, and co-pending patentapplications) cited throughout this application are hereby expresslyincorporated by reference.

EXAMPLES Example 1 Effects of ODNs on B Cell Total RNA Synthesis andCell Cycle

B cells were purified from spleens obtained from 6-12 wk old specificpathogen free DBA/2 or BXSB mice (bred in the University of Iowa animalcare facility; no substantial strain differences were noted) that weredepleted of T cells with anti-Thy-1.2 and complement and centrifugationover lympholyte M (Cedarlane Laboratories, Hornby, Ontario, Canada) (“Bcells”). B cells contained fewer than 1% CD4⁺ or CD8⁺ cells. 8×10⁴ Bcells were dispensed in triplicate into 96 well microtiter plates in 100μl RPMI containing 10% FBS (heat inactivated to 65° C. for 30 min.), 50μM 2-mercaptoethanol, 100 U/ml penicillin, 100 μg/ml streptomycin, and 2mM L-glutamate. 20 μM ODN were added at the start of culture for 20 h at37° C., cells pulsed with 1 μCi of ³H uridine, and harvested and counted4 hr later. Ig secreting B cells were enumerated using the ELISA spotassay after culture of whole spleen cells with ODN at 20 μM for 48 hr.Data, reported in Table 1, represent the stimulation index compared tocells cultured without ODN. ³H thymidine incorporation assays showedsimilar results, but with some nonspecific inhibition by thymidinereleased from degraded ODN (Matson. S and A. M. Krieg (1992) Nonspecificsuppression of ³H-thymidine incorporation by control oligonucleotides.Antisense Research and Development 2:325).

Example 2 Effects of ODN on Production of IgM from B cells

Single cell suspensions from the spleens of freshly killed mice weretreated with anti-Thyl, anti-CD4, and anti-CD8 and complement by themethod of Leibson et al., J. Exp. Med. 154:1681 (1981)). Resting B cells(<02% T cell contamination) were isolated from the 63-70% band of adiscontinuous Percoll gradient by the procedure of DeFranco et al, J.Exp. Med. 155:1523 (1982). These were cultured as described above in 30μM ODN or 20 μg/ml LPS for 48 hr. The number of B cells activelysecreting IgM was maximal at this time point, as determined by ELIspotassay (Klinman, D. M. et al. J. Immunol. 144:506 (1990)). In that assay,B cells were incubated for 6 hrs on anti-Ig coated microtiter plates.The Ig they produced (>99% IgM) was detected using phosphatase-labelledanti-Ig (Southern Biotechnology Associated, Birmingham, Ala.). Theantibodies produced by individual B cells were visualized by addition ofBCIP (Sigma Chemical Co., St. Louis Mo.) which forms an insoluble blueprecipitate in the presence of phosphatase. The dilution of cellsproducing 20-40 spots/well was used to determine the total number ofantibody-secreting B cells/sample. All assays were performed intriplicate (data reported in Table 1). In some experiments, culturesupernatants were assayed for IgM by ELISA, and showed similar increasesin response to CpG-ODN.

Example 3 B cell Stimulation by Bacterial DNA

DBA/2 B cells were cultured with no DNA or 50 μg/ml of a) Micrococcuslysodeikticus; b) NZB/N mouse spleen; and c) NFS/N mouse spleen genomicDNAs for 48 hours, then pulsed with ³H thymidine for 4 hours prior tocell harvest. Duplicate DNA samples were digested with DNAse I for 30minutes at 37 C prior to addition to cell cultures. E coli DNA alsoinduced an 8.8 fold increase in the number of IgM secreting B cells by48 hours using the ELISA-spot assay.

DBA/2 B cells were cultured with either no additive, 50 μg/ml LPS or theODN 1; 1a; 4; or 4a at 20 μM. Cells were cultured and harvested at 4, 8,24 and 48 hours. BXSB cells were cultured as in Example 1 with 5, 10,20, 40 or 80 μM of ODN 1; 1a; 4; or 4a or LPS. In this experiment, wellswith no ODN had 3833 cpm. Each experiment was performed at least threetimes with similar results. Standard deviations of the triplicate wellswere <5%.

Example 4 Effects of ODN on Natural Killer (NK) Activity

10×10⁶ C57BL/6 spleen cells were cultured in two ml RPMI (supplementedas described for Example 1) with or without 40 μM CpG or non-CpG ODN forforty-eight hours. Cells were washed, and then used as effector cells ina short term ⁵¹Cr release assay with YAC-1 and 2C11, two NK sensitivetarget cell lines (Ballas, Z. K. et al. (1993) J. Immunol. 150:17).Effector cells were added at various concentrations to 10⁴ ⁵¹Cr-labeledtarget cells in V-bottom microtiter plates in 0.2 ml, and incubated in5% CO₂ for 4 hr. at 37° C. Plates were then centrifuged, and an aliquotof the supernatant counted for radioactivity. Percent specific lysis wasdetermined by calculating the ratio of the ⁵¹Cr released in the presenceof effector cells minus the ⁵¹Cr released when the target cells arecultured alone, over the total counts released after cell lysis in 2%acetic acid minus the ⁵¹Cr cpm released when the cells are culturedalone.

Example 5 In Vivo Studies with CpG Phosphorothioate ODN

Mice were weighed and injected IP with 0.25 ml of sterile PBS or theindicated phosphorothioate ODN dissolved in PBS. Twenty four hourslater, spleen cells were harvested, washed, and stained for flowcytometry using phycoerythrin conjugated 6B2 to gate on B cells inconjunction with biotin conjugated anti Ly-6A/E or anti-Ia^(d)(Pharmingen, San Diego, Calif.) or anti-Bla-1 (Hardy, R. R. et al., J.Exp. Med. 159:1169 (1984). Two mice were studied for each condition andanalyzed individually.

Example 6 Titration of Phosphorothioate ODN for B Cell Stimulation

B cells were cultured with phosphorothioate ODN with the sequence ofcontrol ODN 1a or the CpG ODN 1d and 3Db and then either pulsed after 20hr with ³H uridine or after 44 hr with ³H thymidine before harvestingand determining cpm.

Example 7 Rescue of B Cells From Apoptosis

WEHI-231 cells (5×10⁴/well) were cultured for 1 hr. at 37 C in thepresence or absence of LPS or the control ODN 1a or the CpG ODN 1d and3Db before addition of anti-IgM (1 μ/ml). Cells were cultured for afurther 20 hr. before a 4 hr. pulse with 2 μCi/well ³H thymidine. Inthis experiment, cells with no ODN or anti-IgM gave 90.4×10³ cpm of ³Hthymidine incorporation by addition of anti-IgM. The phosphodiester ODNshown in Table 1 gave similar protection, though with some nonspecificsuppression due to ODN degradation. Each experiment was repeated atleast 3 times with similar results.

Example 8 In Vivo Induction of Murine IL-6

DBA/2 female mice (2 mos. old) were injected IP with 500 μg CpG orcontrol phosphorothioate ODN. At various time points after injection,the mice were bled. Two mice were studied for each time point. IL-6 wasmeasured by Elisa, and IL-6 concentration was calculated by comparisonto a standard curve generated using recombinant IL-6. The sensitivity ofthe assay was 10 μg/ml. Levels were undetectable after 8 hr.

Example 9 Systemic Induction of Murine IL-6 Transcription

Mice and cell lines. DBA/2, BALB/c, and C3H/HeJ mice at 5-10 wk of agewere used as a source of lymphocytes. All mice were obtained from TheJackson Laboratory (Bar Harbor, Me.), and bred and maintained underspecific pathogen-free conditions in the University of Iowa Animal CareUnit. The mouse B cell line CH12.LX was kindly provided by Dr. G. Bishop(University of Iowa, Iowa City).

Cell preparation. Mice were killed by cervical dislocation. Single cellsuspensions were prepared aseptically from the spleens from mice. T celldepleted mouse splenocytes were prepared by using anti-Thy-1.2 andcomplement and centrifugation over lympholyte M (Cedarlane Laboratories,Hornby, Ontario, Canada) as described (Krieg, A. M. et al., (1989) Arole for endogenous retroviral sequences in the regulation of lymphocyteactivation. J. Immunol. 143:2448).

ODN and DNA. Phosphodiester oligonucleotides (O-ODN) and the backbonemodified phosphorothioate oligonucleotides (S-ODN) were obtained fromthe DNA Core facility at the University of Iowa or from OperonTechnologies (Alameda, Calif.). E. coli DNA (Strain B) and calf thymusDNA were purchased from Sigma (St. Louis, Mo.). All DNA and ODN werepurified by extraction with phenol:chloroform:isoamyl alcohol (25:24:1)and/or ethanol precipitation. E. coli and calf thymus DNA were singlestranded prior to use by boiling for 10 min. followed by cooling on icefor 5 min. For some experiments, E. coli and calf thymus DNA weredigested with DNAse I (2 U/μg of DNA) at 37° C. for 2 hr in 1×SSC with 5mM MgCl₂. To methylate the cytosine in CpG dinucleotides in E. coli DNA,E. coli DNA was treated with CpG methylase (M. SssI; 2U/μg of DNA) inNEBuffer 2 supplemented with 160 μM S-adenosyl methionine and incubatedovernight at 37° C. Methylated DNA was purified as above. Efficiency ofmethylation was confirmed by Hpa II digestion followed by analysis bygel electrophoresis. All enzymes were purchased from New England Biolabs(Beverly, Mass.). LPS level in ODN was less than 12.5 ng/mg and E. coliand calf thymus DNA contained less than 2.5 ng of LPS/mg of DNA byLimulus assay.

Cell Culture. All cells were cultured at 37° C. in a 5% CO₂ humidifiedincubator maintained in RPMI-1640 supplemented with 10% (v/v) heatinactivated fetal calf serum (FCS), 1.5 mM L-glutamine, 50 μg/ml), CpGor non-CpG phosphodiester ODN (O-ODN) (20 μM), phosphorothioate ODN(S-ODN) (0.5 μM), or E. coli or calf thymus DNA (50 μg/ml) at 37° C. for24 hr. (for IL-6 production) or 5 days (for IgM production).Concentrations of stimulants were chosen based on preliminary studieswith titrations. In some cases, cells were treated with CpG O-ODN alongwith various concentrations (1-10 μg/ml) of neutralizing rat IgG1antibody against murine IL-6 (hybridoma MP5-20F3) or control rat IgG1mAb to E. coli β-galactosidase (hybridoma GL113; ATCC, Rockville, Md.)(20) for 5 days. At the end of incubation, culture supernatant fractionswere analyzed by ELISA as below.

In vivo induction of IL-6 and IgM. BALB/c mice were injectedintravenously (iv) with PBS, calf thymus DNA (200 μg/100 μl PBS/mouse),E. coli DNA (200 μg/100 μl PBS/mouse), or CpG or non-CpG S-ODN (200μg/100 μl PBS/mouse). Mice (two/group) were bled by retroorbitalpuncture and sacrificed by cervical dislocation at various time points.Liver, spleen, thymus, and bone marrow were removed and RNA was preparedfrom those organs using RNAzol B (Tel-Test, Friendswood, Tex.) accordingto the manufacturers protocol.

ELISA. Flat-bottomed Immun 1 plates (Dynatech Laboratories, Inc.,Chantilly, Va.) were coated with 100 μ/well of anti-mouse IL-6 mAb(MP5-20F3) (2 μg/ml) or anti-mouse IgM i-chain specific (5 μg/ml; Sigma,St. Louis, Mo.) in carbonate-bicarbonate, pH 9.6 buffer (15 nM Na₂CO₃,35 mM NaHCO₃) overnight at 4° C. The plates were then washed with TPBS(0.5 mM MgCl₂o6H₂0, 2.68 mM KCl, 1.47 mM KH₂PO₄, 0.14 M NaCl, 6.6 mMK₂HP0₄, 0.5% Tween 20) and blocked with 10% FCS in TPBS for 2 hr at roomtemperature and then washed again. Culture supernatants, mouse sera,recombinant mouse IL-6 (Pharmingen, San Diego, Calif.) or purified mouseIgM (Calbiochem, San Diego, Calif.) were appropriately diluted in 10%FCS and incubated in triplicate wells for 6 hr at room temperature. Theplates were washed and 100 μl/well of biotinylated rat anti-mouse IL-6monoclonal antibodies (MP5-32C11, Pharmingen, San Diego, Calif.) (1μg/ml in 10% FCS) or biotinylated anti-mouse Ig (Sigma, St. Louis, Mo.)were added and incubated for 45 min. at room temperature followingwashes with TPBS. Horseradish peroxidase (HRP) conjugated avidin(Bio-rad Laboratories, Hercules, Calif.) at 1:4000 dilution in 10% FCS(100 μl/well) was added and incubated at room temperature for 30 min.The plates were washed and developed with o-phenylendiaminedihydrochloride (OPD; Sigma, St. Louis Mo.) 0.05 M phosphate-citratebuffer, pH 5.0, for 30 min. The reaction was stopped with 0.67 N H₂SO₄and plates were read on a microplate reader (Cambridge Technology, Inc.,Watertown, Mass.) at 490-600 nm. The results are shown in FIGS. 1 and 2.

RT-PCR. A sense primer, an antisense primer, and an internaloligonucleotide probe for IL-6 were synthesized using publishedsequences (Montgomery, R. A. and M. S. Dallman (1991), Analysis ofcytokine gene expression during fetal thymic ontogeny using thepolymerase chain reaction (J. Immunol.) 147:554). cDNA synthesis andIL-6 PCR was done essentially as described by Montgomery and Dallman(Montgomery, R. A. and M. S. Dallman (1991), Analysis of cytokine geneexpression during fetal thymic ontogeny using the polymerase chainreaction (J. Immunol.) 147:554) using RT-PCR reagents from Perkin-ElmerCorp. (Hayward, Calif.). Samples were analyzed after 30 cycles ofamplification by gel electrophoresis followed by unblot analysis (Stoye,J. P. et al., (1991) DNA hybridization in dried gels with fragmentedprobes: an improvement over blotting techniques, Techniques 3:123).Briefly, the gel was hybridized at room temperature for 30 min. indenaturation buffer (0.05 M Na0H, 1.5M NaCl) followed by incubation for30 min. in renaturation buffer (1.5 M NaCl, 1 M Tris, pH 8) and a 30min. wash in double distilled water. The gel was dried and prehybridizedat 47° C. for 2 hr. hybridization buffer (5×SSPE, 0.1% SDS) containing10 μg/ml denatured salmon sperm DNA. The gel was hybridized with 2×10⁶cpm/ml γ-[³²P]ATP end-labeled internal oligonucleotide probe for IL-6(5′CATTTCCACGATTTCCCA3′) SEQ ID NO:56) overnight at 47° C., washed 4times (2×SSC, 0.2% SDS) at room temperature and autoradiographed. Theresults are shown in FIG. 3.

Cell Proliferation assay. DBA/2 mice spleen B cells (5×10⁴ cells/100μl/well) were treated with media, CpG or non-CpG S-ODN (0.5 μM) or O-ODN(20 μM) for 24 hr at 37° C. Cells were pulsed for the last four hr. witheither [³H] Thymidine or [³H] Uridine (1 μCi/well). Amounts of [³H]incorporated were measured using Liquid Scintillation Analyzer (PackardInstrument Co., Downers Grove, Ill.).

Transfections and CAT assays. WEHI-231 cells (10⁷ cells) wereelectroporated with 20 μg of control or human IL-6 promoter-CATconstruct (kindly provided by S. Manolagas, Univ. of Arkansas)(Pottratz, S. T. et al., (1994) 17B-estradiol inhibits expression ofhuman interleukin-6 promoter-reporter constructs by a receptor-dependentmechanism. J. Clin. Invest. 93:944) at 250 mV and 960 μF. Cells werestimulated with various concentrations or CpG or non-CpG ODN afterelectroporation. Chloramphenicol acetyltransferase (CAT) activity wasmeasured by a solution assay (Seed, B. and J. Y. Sheen (1988) A singlephase-extraction assay for chloramphenicol acetyl transferase activity.Gene 76:271) 16 hr. after transfection. The results are presented inFIG. 5.

Example 10 Oligodeoxynucleotide Modifications Determine the Magnitude ofB Cell Stimulation by CpG Motifs

ODN were synthesized on an Applied Biosystems Inc. (Foster City, Calif.)model 380A, 380B, or 394 DNA synthesizer using standard procedures(Beacage and Caruthers (1981) Deoxynucleoside phosphoramidites—A newclass of key intermediates for deoxypolynucleotide synthesis.Tetrahedron Letters 22, 1859-1862). Phosphodiester ODN were synthesizedusing standard beta-cyanoethyl phosphoramidite chemistry.Phosphorothioate linkages were introduced by oxidizing the phosphitelinkage with elemental sulfur instead of the standard iodine oxidation.The four common nucleoside phosphoramidites were purchased from AppliedBiosystems. All phosphodiester and thioate containing ODN weredeprotected by treatment with concentrated ammonia at 55° C. for 12hours. The ODN were purified by gel exclusion chromatography andlyophilized to dryness prior to use. Phosphorodithioate linkages wereintroduced by using deoxynucleoside S-(b-benzoylmercaptoethyl)pyrrolidino thiophosphoramidites (Wiesler, W. T. et al., (1993) InMethods in Molecular Biology: Protocols for Oligonucleotides andAnalogs—Synthesis and Properties, Agrawal, S. (ed.), Humana Press,191-206). Dithioate containing ODN were deprotected by treatment withconcentrated ammonia at 55° C. for 12 hours followed by reverse phaseHPLC purification.

In order to synthesize oligomers containing methylphosphonothioates ormethylphosphonates as well as phosphodiesters at any desiredinternucleotide linkage, two different synthetic cycles were used. Themajor synthetic differences in the two cycles are the coupling reagentwhere dialkylaminomethylnucleoside phosphines are used and the oxidationreagents in the case of methylphosphonothioates. In order to synthesizeeither derivative, the condensation time has been increased for thedialkylaminomethylnucleoside phosphines due to the slower kinetics ofcoupling (Jager and Engels, (1984) Synthesis of deoxynucleosidemethylphosphonates via a phosphonamidite approach. Tetrahedron Letters24, 1437-1440). After the coupling step has been completed, themethylphosphinodiester is treated with the sulfurizing reagent (5%elemental sulfur, 100 millimolar N,N-diamethylaminopyridine in carbondisulfide/pyridine/triethylamine), four consecutive times for 450seconds each to produce methylphosphonothioates. To producemethylphosphonate linkages, the methylphosphinodiester is treated withstandard oxidizing reagent (0.1 M iodine intetrahydrofuran/2,6-lutidine/water).

The silica gel bound oligomer was treated with distilledpyridine/concentrated ammonia, 1:1, (v/v) for four days at 4 degreescentigrade. The supernatant was dried in vacuo, dissolved in water andchromatographed on a G50/50 Sephadex column.

As used herein, O-ODN refers to ODN which are phosphodiester; S-ODN arecompletely phosphorothioate modified; S-O-ODN are chimeric ODN in whichthe central linkages are phosphodiester, but the two 5′ and five 3′linkages are phosphorothioate modified; S₂-O-ODN are chimeric ODN inwhich the central linkages are phosphodiester, but the two 5′ and five3′ linkages are phosphorodithioate modified; and MP-O-ODN are chimericODN in which the central linkages are phosphodiester, but the two 5′ andfive 3′ linkages are methylphosphonate modified. The ODN sequencesstudied (with CpG dinucleotides indicated by underlining) include:

3D (5′ GAGAACGCTGGACCTTCCAT),; (SEQ ID NO:14) 3M (5′TCCATGTCGGTCCTGATGCT),; (SEQ ID NO:22) 5 (5′ GGCGTTATTCCTGACTCGCC),;(SEQ ID NO:57) and 6 (5′ CCTACGTTGTATGCGCCCAGCT),. (SEQ ID NO:58)These sequences are representative of literally hundreds of CpG andnon-CpG ODN that have been tested in the course of these studies.

Mice. DBA/2, or BXSB mice obtained from The Jackson Laboratory (BarHarbor, Me.), and maintained under specific pathogen-free conditionswere used as a source of lymphocytes at 5-10 wk of age with essentiallyidentical results.

Cell proliferation assay. For cell proliferation assays, mouse spleencells (5×10⁴ cells/100 μl/well) were cultured at 37° C. in a 5% CO₂humidified incubator in RPMI-1640 supplemented with 10% (v/v) heatinactivated fetal calf serum (heated to 65° C. for experiments withO-ODN, or 56° C. for experiments using only modified ODN), 1.5 μML-glutamine, 50 μM 2-mercaptoethanol, 100 U/ml penicillin and 100 μg/mlstreptomycin for 24 hr or 48 hr as indicated. 1 μCi of ³H uridine orthymidine (as indicated) was added to each well, and the cells harvestedafter an additional 4 hours of culture. Filters were counted byscintillation counting. Standard deviations of the triplicate wells were<5%. The results are presented in FIGS. 6-8.

Example 11 Induction of NK Activity

Phosphodiester ODN were purchased from Operon Technologies (Alameda,Calif.). Phosphorothioate ODN were purchased from the DNA core facility,University of Iowa, or from The Midland Certified Reagent Company(Midland Tex.). E. coli (strain B) DNA and calf thymus DNA werepurchased from Sigma (St. Louis, Mo.). All DNA and ODN were purified byextraction with phenol:chloroform:isoamyl alcohol (25:24:1) and/orethanol precipitation. The LPS level in ODN was less than 12.5 ng/mg andE. coli and calf thymus DNA contained less than 2.5 ng of LPS/mg of DNAby Limulus assay.

Virus-free, 4-6 week old, DBA/2, C57BL/6 (B6) and congenitally athymicBALB/C mice were obtained on contract through the Veterans Affairs fromthe National Cancer Institute (Bethesda, Md.). C57BL/6 SCID mice werebred in the SPF barrier facility at the University of Iowa Animal CareUnit.

Human peripheral mononuclear blood leukocytes (PBMC) were obtained aspreviously described (Ballas, Z. K. et al., (1990) J. Allergy Clin.Immunol. 85:453; Ballas, Z. K. and W. Rasmussen (1990) J. Immunol.145:1039; Ballas, Z. K. and W. Rasmussen (1993) J. Immunol. 150; 17).Human or murine cells were cultured at 5×10⁶/well, at 37° C. in a 5% CO₂humidified atmosphere in 24-well plates (Ballas, Z. K. et al., (1990) J.Allergy Clin. Immunol. 85:453; Ballas, Z. K. and W. Rasmussen (1990) J.Immunol 145:1039; and Ballas, Z. K. and W. Rasmussen (1993) J. Immunol,150:17), with medium alone or with CpG or non-CpG ODN at the indicatedconcentrations, or with E. coli or calf thymus (50 μg/ml) at 37° C. for24 hr. All cultures were harvested at 18 hr. and the cells were used aseffectors in a standard 4 hr. ⁵¹Cr-release assay against K562 (human) orYAC-1 (mouse) target cells as previously described. For calculation oflytic units (LU), 1 LU was defined as the number of cells needed toeffect 30% specific lysis. Where indicated, neutralizing antibodiesagainst IFN-β (Lee Biomolecular, San Diego, Calif.) or IL-12 (C15.1,C15.6, C17.8, and C17.15; provided by Dr. Giorgio Trinchieri, The WistarInstitute, Philadelphia, Pa.) or their isotype controls were added atthe initiation of cultures to a concentration of 10 μg/ml. Foranti-IL-12 addition, 10 μg of each of the 4 MAB (or isotype controls)were added simultaneously. Recombinant human IL-2 was used at aconcentration of 100 U/ml.

Example 12 Prevention of the Development of an Inflammatory CellularInfiltrate and Eosinophilia in a Murine Model of Asthma

6-8 week old C56BL/6 mice (from The Jackson Laboratory, Bar Harbor, Me.)were immunized with 5,000 Schistosoma mansoni eggs by intraperitoneal(i.p.) injection on days 0 and 7. Schistosoma mansoni eggs contain anantigen (Schistosoma mansoni egg antigen (SEA)) that induces a Th2immune response (e.g. production of IgE antibody). IgE antibodyproduction is known to be an important cause of asthma.

The immunized mice were then treated with oligonucleotides (30 μg in 200μl saline by i.p. injection), which either contained an unmethylated CpGmotif (i.e. TCCATGACGTTCCTGACGTT; SEQ ID NO.10) or did not (i.e.control, TCCATGAGCTTCCTGAGTCT; SEQ ID NO.11). Soluble SEA (10 μg in 25μl of saline) was administered by intranasal instillation on days 14 and21. Saline was used as a control.

Mice were sacrificed at various times after airway challenge. Whole lunglavage was performed to harvest airway and alveolar inflammatory cells.Cytokine levels were measured from lavage fluid by ELISA. RNA wasisolated from whole lung for Northern analysis and RT-PCR studies usingCsCl gradients. Lungs were inflated and perfused with 4%paraformaldehyde for histologic examination.

FIG. 9 shows that when the mice are initially injected with the eggsi.p., and then inhale the egg antigen (open circle), many inflammatorycells are present in the lungs. However, when the mice are initiallygiven a nucleic acid containing an unmethylated CpG motif along with theeggs, the inflammatory cells in the lung are not increased by subsequentinhalation of the egg antigen (open triangles).

FIG. 10 shows that the same results are obtained when only eosinophilspresent in the lung lavage are measured. Eosinophils are the type ofinflammatory cell most closely associated with asthma.

FIG. 11 shows that when the mice are treated with a control oligo at thetime of the initial exposure to the egg, there is little effect on thesubsequent influx of eosinophils into the lungs after inhalation of SEA.Thus, when mice inhale the eggs on days 14 or 21, they develop an acuteinflammatory response in the lungs. However, giving a CpG oligo alongwith the eggs at the time of initial antigen exposure on days 0 and 7almost completely abolishes the increase in eosinophils when the miceinhale the egg antigen on day 14.

FIG. 12 shows that very low doses of oligonucleotide (<10 μg) can givethis protection.

FIG. 13 shows that the resultant inflammatory response correlates withthe levels of the Th2 cytokine IL-4 in the lung.

FIG. 14 shows that administration of an oligonucleotide containing anunmethylated CpG motif can actually redirect the cytokine response ofthe lung to production of Il-12, indicating a Th1 type of immuneresponse.

FIG. 15 shows that administration of an oligonucleotide containing anunmethylated CpG motif can also redirect the cytokine response of thelung to production of IFN-γ, indicating a Th1 type of immune response.

Example 13 CpG Oligonucleotides Induce Human PBMC to Secrete Cytokines

Human PBMC were prepared from whole blood by standard centrifugationover ficoll hypaque. Cells (5×10⁵/ml) were cultured in 10% autologousserum in 96 well microtiter plates with CpG or controloligodeoxynucleotides (24 μg/ml for phosphodiester oligonucleotides; 6μg/ml for nuclease resistant phosphorothioate oligonucleotides) for 4 hrin the case of TNF-α or 24 hr. for the other cytokines beforesupernatant harvest and assay, measured by ELISA using Quantikine kitsor reagents from R&D Systems (pg/ml) or cytokine ELISA kits fromBiosource (for IL-12 assay). Assays were performed as per themanufacturer's instructions. Data are presented in Table 6 as the levelof cytokine above that in wells with no added oligodeoxynucleotide.

EQUIVALENTS

Those skilled in the art will recognize, or be able to ascertain usingno more than routine experimentation, many equivalents of the specificembodiments of the invention described herein. Such equivalents areintended to be encompassed by the following claims.

1. An immunostimulatory nucleic acid composition comprising a syntheticnucleic acid comprising an unmethylated CpG dinucleotide, wherein thenucleic acid contains a diol at either or both termini, wherein the diolis a tetraethyleneglycol or hexaethyleneglycol.
 2. An immunostimulatorynucleic acid composition comprising a synthetic nucleic acid comprisingan unmethylated CpG dinucleotide, wherein the nucleic acid comprises adiol.
 3. An immunostimulatory nucleic acid composition comprising asynthetic nucleic acid comprising an unmethylated CpG dinucleotide,wherein the nucleic acid comprises a diol at either terminus.
 4. Animmunostimulatory nucleic acid composition comprising a syntheticnucleic acid comprising an unmethylated CpG dinucleotide, wherein thenucleic acid comprises a diol at both termini.
 5. The immunostimulatorynucleic acid composition of claim 2, wherein the diol istetraethyleneglycol or hexaethyleneglycol.
 6. The immunostimulatorynucleic acid composition of any one of claims 1-5, wherein theimmunostimulatory nucleic acid composition has the ability to stimulateinterferon-gamma or interferon-alpha secretion by spleen cells or humanperipheral blood mononuclear cells.
 7. The immunostimulatory nucleicacid composition of any one of claims 1-5, wherein the synthetic nucleicacid comprises a motif represented by the formula 5′X₁X₂CGX₃X₄3′,wherein C is unmethylated, and X₁, X₂, X₃ and X₄ are nucleotides.
 8. Theimmunostimulatory nucleic acid composition of any one of claims 1-5,wherein the nucleic acid comprises a 5′ TC at its 5′ end.
 9. Theimmunostimulatory nucleic acid composition of any one of claims 1-5,wherein the nucleic acid comprises a 5′ TCG 3′.
 10. Theimmunostimulatory nucleic acid composition of any one of claims 1-5,wherein the nucleic acid comprises a 5′ TCGT 3′.
 11. Theimmunostimulatory nucleic acid composition of any one of claims 1-5,wherein the nucleic acid comprises a phosphodiester backbone.
 12. Theimmunostimulatory nucleic acid composition of any one of claims 1-5,wherein the nucleic acid comprises a modified backbone.
 13. Theimmunostimulatory nucleic acid composition of claim 12, wherein thenucleic acid is phosphorothioate or phosphorodithioate modified nucleicacid.
 14. The immunostimulatory nucleic acid composition of any one ofclaims 1-5, further comprising a pharmaceutically acceptable carrier.15. The immunostimulatory nucleic acid composition of any one of claims1-5, further comprising an antigen.
 16. The immunostimulatory nucleicacid composition of claim 1, further comprising a cationic lipid. 17.The immunostimulatory nucleic acid composition of any one of claims 1-5,wherein the nucleic acid is an oligonucleotide.
 18. Theimmunostimulatory nucleic acid composition of claim 1, wherein thenucleic acid is less than 100 nucleotides long.
 19. Theimmunostimulatory nucleic acid composition of claim 1, wherein thenucleic acid is 2-100 nucleotides long.
 20. The immunostimulatorynucleic acid composition of claim 1, wherein the nucleic acid is 6-100nucleotides long.
 21. The immunostimulatory nucleic acid composition ofclaim 1, wherein the nucleic acid is 8-40 nucleotides long.
 22. Theimmunostimulatory nucleic acid composition of claim 6 wherein thesynthetic nucleic acid comprises a motif represented by the formula5′X₁X₂CGX₃X₄3′, wherein C is unmethylated, and X₁, X₂, X₃ and X₄ arenucleotides.
 23. The immunostimulatory nucleic acid composition of claim1, wherein the immunostimulatory nucleic acid comprises an alkylphosphonate, an aryl phosphonate or alkylphosphotriester.
 24. Theimmunostimulatory nucleic acid composition of claim 2, wherein theimmunostimulatory nucleic acid comprises an alkyl phosphonate, an arylphosphonate or alkylphosphotriester.
 25. The immunostimulatory nucleicacid composition of claim 3, wherein the immunostimulatory nucleic acidcomprises an alkyl phosphonate, an aryl phosphonate oralkylphosphotriester.
 26. The immunostimulatory nucleic acid compositionof claim 4, wherein the immunostimulatory nucleic acid comprises analkyl phosphonate an aryl phosphonate or alkylphosphotriester.
 27. Theimmunostimulatory nucleic acid composition of claim 5, wherein theimmunostimulatory nucleic acid comprises an alkyl phosphonate, an arylphosphonate or alkylphosphotriester.